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A client had a retinal detachment and has undergone surgical correction. What discharge instruction is most important?
- A. Avoid reading, writing, or close work.
- B. Blind the lights in your house for at least a work.
- C. Keep the follow-up appointment with the ophthalmologist.
- D. Remove the eye patch to instill eyedrops.
Correct Answer: A
Rationale: After surgery for retinal detachment, the client is advised to avoid reading, writing, and close work because they cause rapid eye movements that could disrupt healing. Dim lights are not indicated, keeping postoperative appointments is important but not specific to retinal detachment, and the eye patch is not removed for eyedrops.
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A client has been taught about retinitis pigmentosa (RP). What statement by the client indicates a need for further teaching?
- A. I should continue wearing sunglasses.
- B. Beta carotene, lutein, and zeaxanthin are good supplements.
- C. I may qualify for a retinal transplant one day soon.
- D. Vitamin A has been shown to slow progression of RP.
Correct Answer: C
Rationale: Retinal transplants are not a current or near-future treatment for retinitis pigmentosa. Sunglasses help protect against cataracts, and supplements like beta carotene, lutein, zeaxanthin, and vitamin A may slow RP progression.
A nurse is seeing clients in the ophthalmology clinic. Which client should the nurse see first?
- A. Client with intraocular pressure reading of 24 mm Hg
- B. Client who has had cataract surgery and has worsening vision
- C. Client whose red reflex is absent on ophthalmologic examination
- D. Client with a tearing, reddened eye with exudate.
Correct Answer: B
Rationale: Worsening vision after cataract surgery indicates a potential infection or other complication, which requires urgent attention. An intraocular pressure of 24 mm Hg is slightly elevated, an absent red reflex may indicate cataracts, and a tearing eye may suggest an infection but is less urgent.
The nurse working in the ophthalmology clinic sees clients with eyelid and eye problems. What information should the nurse understand about these disorders? (Select all that apply.)
- A. A chalazion is an inflammation of an eyelid sebaceous gland.
- B. An ectropion is the eyelid turning outward.
- C. An entropion is the eyelid turning outward.
- D. A hordeolum is an infection of the eyelid sweat gland.
- E. Keratoconjunctivitis sicca is caused by drugs or diseases.
Correct Answer: A,D,E
Rationale: A chalazion is an inflammation of one of the sebaceous glands in the eyelid. A hordeolum is an infection of a sweat gland in the eyelid. Keratoconjunctivitis sicca can be caused by drugs or diseases. An ectropion is an outward turning and sagging eyelid, while an entropion is an inward turning of the eyelid.
A client asks why blindness occurred from glaucoma. What explanation by the nurse is best?
- A. Because eye pressure was too high, the tissue died.
- B. Glaucoma always leads to permanent blindness.
- C. The traumatic damage to your eye was too great.
- D. The infection occurs so quickly, it can be treated.
Correct Answer: A
Rationale: Glaucoma is caused when the intraocular pressure becomes too high and stays high long enough to cause tissue ischemia and death. At that point, vision loss is permanent. Glaucoma does not always cause blindness, trauma is not the most common cause, and glaucoma is not an infection.
A client is taking timolol (Timoptic) eyedrops. The nurse assesses the clients pulse at 50 beats/min. What action by the nurse is best?
- A. Administer the eyedrops as ordered.
- B. Assess the client for excessive salivation.
- C. Assess the client for shortness of breath.
- D. Hold the eyedrops and notify the provider.
Correct Answer: D
Rationale: Timolol is a beta blocker that can slow the heart rate. A pulse of 50 beats/min warrants holding the eyedrops and notifying the provider. Excessive salivation and shortness of breath are not typically related to timolol.