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A patient with a diagnosis of retinal detachment has undergone a vitreoretinal procedure on an outpatient basis. What subject should the nurse prioritize during discharge education?
- A. Risk factors for postoperative cytomegalovirus (CMV)
- B. Compensating for vision loss for the next several weeks
- C. Non-pharmacologic pain management strategies
- D. Signs and symptoms of increased intraocular pressure
Correct Answer: D
Rationale: Educating about signs of increased intraocular pressure and infection is critical post-vitreoretinal surgery to prevent complications. CMV, vision loss, and pain are less urgent concerns.
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The nurse should recognize the greatest risk for the development of blindness in which of the following patients?
- A. A 58-year-old Caucasian woman with macular degeneration
- B. A 28-year-old Caucasian man with astigmatism
- C. A 58-year-old African American woman with hyperopia
- D. A 28-year-old African American man with myopia
Correct Answer: A
Rationale: Macular degeneration, prevalent in older adults, is a leading cause of blindness. Astigmatism, hyperopia, and myopia are refractive errors with lower blindness risk.
Cytomegalovirus (CMV) is the most common cause of retinal inflammation in patients with AIDS. What drug, surgically implanted, is used for the acute stage of CMV retinitis?
- A. Pilocarpine
- B. Penicillin
- C. Ganciclovir
- D. Gentamicin
Correct Answer: C
Rationale: Ganciclovir implants deliver high concentrations to treat CMV retinitis. Pilocarpine treats glaucoma, and penicillin and gentamicin are ineffective against CMV.
A hospitalized patient with impaired vision must get a picture in his or her mind of the hospital room and its contents in order to mobilize independently and safely. What must the nurse monitor in the patients room?
- A. That a commode is always available at the bedside
- B. That all furniture remains in the same position
- C. That visitors do not leave items on the bedside table
- D. That the patients slippers stay under the bed
Correct Answer: B
Rationale: Consistent furniture placement reduces fall risk for visually impaired patients. Commodes, bedside table items, and slipper placement are secondary concerns.
When administering a patients eye drops, the nurse recognizes the need to prevent absorption by the nasolacrimal duct. How can the nurse best achieve this goal?
- A. Ensure that the patient is well hydrated at all times.
- B. Encourage self-administration of eye drops.
- C. Occlude the puncta after applying the medication.
- D. Position the patient supine before administering eye drops.
Correct Answer: C
Rationale: Occluding the puncta prevents nasolacrimal duct absorption, reducing systemic side effects. Hydration, self-administration, and supine positioning do not address this issue.
A patient has had a sudden loss of vision after head trauma. How should the nurse best describe the placement of items on the dinner tray?
- A. Explain the location of items using clock cues.
- B. Explain that each of the items on the tray is clearly separated.
- C. Describe the location of items from the bottom of the plate to the top.
- D. Ask the patient to describe the location of items before confirming their location.
Correct Answer: A
Rationale: Clock cues (e.g., meat at 3 o'clock) effectively orient a visually impaired patient to tray items. Separation, top-to-bottom descriptions, or patient guesses are less practical.