A client who has been treated for chronic open-angle glaucoma for 5 years asks the nurse, “How does glaucoma damage my eyesight?” What should the
... [Show More] nurse tell the client? “Your glaucoma:
a. results from chronic eye inflammation.“
b. causes increased intraocular pressure.“
c. leads to detachment of the retina.“
d. is caused by decreased blood flow to the retina."
B
In COAG, there is an obstruction to the outflow of aqueous humor, leading to increased intraocular pressure. The increased intraocular pressure eventually causes destruction of the retina’s nerve fibers. This nerve destruction causes painless vision loss. The exact cause of glaucoma is unknown. Glaucoma does not lead to retinal detachment.
The nurse is administering eye drops to a client with glaucoma. Which technique is correct for instilling the eye drops? The eye drops are placed:
a. in the lower conjunctival sac.
b. near the opening of the lacrimal ducts.
c. on the cornea.
d. on the scleral surface.
A
Eyedrops are correctly instilled by placing them in the lower conjunctival sac. Eyedrops should not be placed near the lacrimal ducts, to decrease the chance of the medication’s being systemically absorbed. Placing the drops on the cornea or sclera is uncomfortable for the client and may cause the medication to run out of the eye socket instead of being absorbed.
When checking a client's medication profile, a nurse notes that the client is receiving a drug contraindicated for clients with glaucoma. The nurse knows that this client, who has a history of glaucoma, has been taking the medication for the past 3 days. What should the nurse do first?
a. Continue to give the medication because the client has been taking it for 3 days.
b. Hold the medication and report the information to the physician to ensure client safety.
c. File an incident report because several other staff members have given the medication to the client.
d. Find out whether there are extenuating reasons for giving the drug to this client.
B
The nurse should report the information to the physician because the client's safety may be endangered. The nurse shouldn't give the drug until clarifying the order with the physician. The fact that the client has taken the drug for several days doesn't guarantee that giving another dose is safe. Filing an incident report and finding out whether there are extenuating reasons for giving the drug wouldn't address client safety.
The client asks when to stop taking the eye medication for chronic open-angle glaucoma. The nurse should tell the client:
a. to stop using the eyedrops when the vision improves.
b. to use the eyedrops only when there are symptoms.
c. to discontinue the eyedrops after 2 months of normal eye examinations.
d. to use the eye medication for the rest of life.
D
To control increased intraocular pressure, the client will need to continue taking eye medications for the rest of life. Intraocular pressure will increase if medications are discontinued.
Any loss of vision that the client has suffered will be permanent. Vision loss can occur gradually without any symptoms.
A client has been diagnosed with an acute episode of angle-closure glaucoma. The client asks the nurse what will be done. What should the nurse tell the client about this health problem? Acute angle-closure glaucoma:
a. frequently resolves without treatment.
b. is typically treated with sustained bed rest.
c. is a medical emergency that can rapidly lead to blindness.
d. is most commonly treated with steroid therapy.
C
Acute angle-closure glaucoma is a medical emergency that rapidly leads to blindness if left untreated. Treatment typically involves miotic drugs and surgery, usually iridectomy or laser therapy. Both procedures create a hole in the periphery of the iris, which allows the aqueous humor to flow into the anterior chamber. Bed rest does not affect the progression of acute angle-closure glaucoma. Steroids are not a treatment for acute angle-closure glaucoma; in fact, they are associated with the development of glaucoma.
To decrease intraocular pressure following cataract surgery, what should the nurse instruct the client to avoid?
a. lying supine
b. Coughing
c. deep breathing
d. ambulation
B
Coughing is contraindicated after cataract extraction because it increases intraocular pressure. Other activities that are contraindicated because they increase intraocular pressure include turning to the operative side, sneezing, crying, and straining. Lying supine, ambulating, and deep breathing do not affect intraocular pressure. [Show Less]