CATARACT 2.

PHACOEMULSIFICATION

RISK FACTORS: -small incision

-phacoemulsifier tip
A-ging
uses UTZ vibration
I-njury
D-rug:
3. INTRACAPSULAR CATARACT EXTRACTION
S-un exposure
-removal:
S-ystemic disease
-cryoextraction:
S-moking

↓O2 uptake
4. PERIPHERAL IRIDECTOMY
↓
-small hole in the iris
Lens 
↓
NURSING MANAGEMENT
Problem:
1. PROMOTE SAFETY
↓
-orientation
Obstruction of light reception
-side rails:
-call light
S/S
-assist 
1. Blurred vision
2. Painless
2. PROTECT EYES
3. Intolerance to glare
-don’t rub
-for discomfort:
NSG DX:
-1st 24 H:
-1-4 weeks
DIAGNOSTIC TEST
daytime:
1. SLIT LAMP TEST
nighttime:
R:

3. REDUCE IOP (HEALTH TEACHINGS)

SURGERIES
-eye drops
CATARACT REMOVAL
-position:
-indication: vision
-cx: HEMORRHAGE
-one eye at a time
-avoid :
-anesthesia:
Bending
-pre-op drugs:
Lifting
Mydriatic
Straining give:
*cyclopentolate (Cyclogyl)
Vomiting give:
1. EXTRACAPSULAR CATARACT EXTRACTION
Brushing vigorously  teeth & hair
-SX of choice:
-removal:
GLAUCOMA
-posterior capsule (left in place)
RISK FACTORS:
-cx: APHAKIA
A-ge:
B-lacks
 C-ardiac problems -examine anterior chamber angle
DM -R: closure 
E-ye Trauma
2 TYPES DRUGS
Chronic Glaucoma 1. MIOTICS
drainage: A. CHOLINERGIC
Acute Glaucoma -pilocarpine (Pilocar)
iris forward displacement -acetylcholine (Miochol)
↓ action:
angle between iris & cornea: monitor V/S
↓ antidote:
obstruction
B. OPTIC BETA BLOCKERS
Pathophysiology -timolol (Timoptic)
aqueous fluid buildup -betaxolol (Beoptic)
↓ action: constrict pupil
IOP ↓ production:
↓
inhibits blood supply  nerve: 2. CARBONIC ANHYDRASE INHIBITORS
↓ -acetazolamide (Diamox)
ischemia action:
↓ harmful:
blindness:
vision loss SURGERIES
S/S 1. TRABECULECTOMY
T-unnel vision -creation:
-purpose:
H-alos around light
2. LASER TRABECULECTOMY
Eye pain -noninvasive
for acute/close -done: ambulatory
if chronic/open: -using of argon laser
Nausea and vomiting
3. PERIPHERAL IRIDECTOMY
DIAGNOSTIC TESTS -excision: iris portion
1. Tonometry -goal:
Normal
R NURSING MANAGEMENT
1. REDUCE IOP
2. Perimetry -position:
R: -can watch TV or read
-avoid:
3. Gonioscopy >bending, lifting & straining
2. HEALTH TEACHING SURGERIES
-glaucoma: controllable 1. CRYOTHERAPY
-eye drops: -probe
-instruction: -creates scar
-during sleep:
-avoid: 2. SCLERAL BUCKLING
>SNS: -standard tx
>driving -goal:
>cold preparations -use of sclera buckle

RETINAL DETACHMENT NURSING MANAGEMENT

RISK FACTORS: 1. PREVENT FURTHER DETACHMENT
M-yopia -X abrupt head movement
A-ging -X prone
T-rauma -eye patch
C-ataract Sx
H-eredity 2. POST-SURGERY
↓ A. PREVENT INJURY (EYE MOVEMENT)
retinal break: -orientation
↓ -bed rest:
liquid passage from vitreous gel -eye patch
↓ -prevent rubbing
buildup of fluid: -X reading
↓ -approach:
problem: -if scleral buckling position:

S/S B. HEALTH TEACHINGS

1. Initial -avoid: >bending/stooping
F >heavy lifting
F >straining
Falling curtains >coughing
-activity resumption  gradual
2. Black Spots
OTOSCLEROSIS
3. Painless RISK FACTORS:
1. Heredity
DX TEST 2. Gender
1. OPHTHALMOSCOPY ↓
-confirmatory Problem: bony 
-R: ↓
fixation of stapes
↓
Stapes CANNOT:
 ↓ >sneezing
(-) sound transmission >straining
>heavy lifting
S/S >drinking thru straw
1. Hearing loss  >bending
2. Tinnitus >swimming/shower
3. Assessment: eardrum chalky >washing hair

DX TEST MENIERE’S DISEASE

1. RINNE’S TEST RISK FACTORS:
N: S-moking
R: H-igh salt intake
E-ar infection
2. WEBER TEST A-llergy
-tuning fork: T-rauma (head)
-R: H-ereditary
>equal: ↓
>good ear: Increase production:
>poor ear: ↓
excessive dilation
3. AUDIOMETRY ↓
R: pressure
↓
SX affectation:
STAPEDECTOMY Cochlear duct
-removal: Vestibular
diseased portion S/S
replacement: 1. TRIAD: >Hearing Loss
-purpose: >Vertigo
>Tinnitus
NURSING MANAGEMENT
1. SAFETY & PREVENT VERTIGO 2. Fullness in the ear
-position  if prevent displacement:
-avoid rapid turning 3. Nausea
-medications
2. HEALTH TEACHINGS Nsg DX:
A. PREVENT ↑ EAR PRESSURE
-avoid: >air travel DX TESTS
>high altitude 1. RINNE’s TEST
>sudden head movement -N:
>very loud sound -R:
>coughing A>B (more than X 2) =
>blowing of nose
2. WEBER TEST
-tuning fork:
-R:
equal:
good ear:
poor ear:

DRUGS
1. ANTIHISTAMINE
-meclizine (Antivert)
-dimenhydrinate (Dramamine)
-diphenhydramine (Benadryl)
-action:

2. ANTIEMETICS
-promethazine (Phenergan)
-action:

3. DIURETICS
-hydrochlorothiazide
-action:

NURSING MANAGEMENT
1. SAFETY - CONTROL VERTIGO (No Cure!)
-during attack: lie flat /sit or reclining
-lying down: >keep eyes open
>stare straight ahead
-X sudden head movement
-turning: entire body
-change position gradually
-side rails
-balance therapy exercise
-X driving

2. MINIMIZE ATTACKS
-diet:
-restrict:
-↓tinnitus occurrence
-cope tinnitus: