GIANNA RONA BEATRIZ D.

BAGA BSN 3-C

GIANNA RONA BEATRIZ D. BAGA BSN 3-C
GIANNA RONA BEATRIZ D. BAGA BSN 3-C
GIANNA RONA BEATRIZ D. BAGA BSN 3-C
GIANNA RONA BEATRIZ D. BAGA BSN 3-C
Documentation:
GIANNA RONA BEATRIZ D. BAGA BSN 3-C

NCP

Nursing Assessment
Subjective:
“Adda bassit marikriknak nga sakit na ditoy aglawlaw ti matak ken adda ti pinagkapsot ti pinagkitak.” As verbalized by
the patient.
Objective:
 Cloudy pupils
 Sudden/persistent severe pain or pressure in and around eyes
 Headache
 V/S taken:
T: 37C
P: 80
R: 18
Nursing Diagnosis:
1. Disturbed visual sensory perception r/t altered sensory reception
Nursing Inference:
Increased intraocular pressure

Inadequate drainage of aqueous humor from the anterior chamber of the eye

Atrophy of the optic nerve

Disturbed visual sensory

Nursing Goal
After 8 hours of nursing intervention the patient will:
 Participate in therapeutic regimen
 Maintain current visual field/acuity without further loss

Nursing Intervention Rationale

1. Ascertain type/degree of visual loss
2. Encourage expression of feelings about loss/possibility
of loss of vision
3. Recommend measures to assist patient to manage
visual limitations
1. Affects choice of interventions and patient’s future
expectations
2. Early intervention can prevent blindness, patient faces
possibility or may have complete loss, or cannot restored
3. Reduces safety hazards related to changes in visual
fields/loss

Evaluation:
Goal met, patient has maintained current visual field/acuity without further loss