ASSESSMENT DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION
Subjective Risk for injury related Short Term: Determine the Raises awareness of Short term:
- 68-year-old Indian to The client will be able severity of the the problem and The client developed
woman. “can’t see as changes in the eyes to patient's condition determines its behavior and lifestyle
well as I used to.” due develop behavior and due to a visual severity, allowing for adjustments that will
-Retired from the to aging and/or night lifestyle impairment. the creation of a minimize the risk
telephone company blindness as modifications that Encourage the treatment plan. factor, as well as
for 3 years. evidenced by will minimize the risk patient to have a To keep an eye on execute safety
- Has 71-year-old blurred vision, halo factor, as well as routine medical the progression of measures, after 24
husband that had a effect, adopt examination with the eyesight loss and hours of nurse
major stroke 1 year and verbal complaint safety measures, assistance of an treat it appropriately. intervention.
ago and is of after 24 ophthalmologist Elderly patients
responsible for his poor visual acuity hours of nurse care. once a year, at the require double the Long Term:
care. very least. amount of light as After 3 to 4 days of
-Live in a small one- Long Term: Allow enough light younger patients. nurse intervention,
story house and have After 3 to 4 days of for the patient to The danger of harm the patient was able
a car. nursing intervention, carry out his or her is reduced when to notice and correct
-Their daughter and the activities. there is enough for changes, resulting
her family live 321.8 patient will be able Provide illumination. in improved visual
km (200 miles) away. to illumination that The eyes of elderly acuity within the
-Reports progressive recognize the avoids glare on patients are more constraints of
changes in her vision unsettling surfaces such as susceptible to glare, particular settings.
over the past 5 influences and walls, books, and and cataracts diffuse GOAL WAS MET
months. compensate against other reading items. and glare, causing
-“Blurring that changes; hence; Instruct the patient visual difficulties.
seems to be getting improving visual to keep an eye out This might be a sign
worse” sharpness inside the for signs of problems, of infection and
-Reports a halo effect limits such as severe pain should be reported
at night when looking of personal in the eye that isn't right away. Patients
at lights. circumstances. relieved by analgesics may not be able to
-Has worn glasses for or anterior chamber execute all of the
reading for the past clouding. responsibilities
20 years. Denies eye Encourage the associated with
pain, swelling, patient to include personal care.
excessive tearing, or foods rich in vitamins Patients with
discharge. C, E, beta-carotene, impaired intellect or
-Had an eye zinc, and copper in sensory impairments
examination 4 her diet, as directed are unable to
years ago. by her physician daily distinguish between
-States that she has suggested intake. temperature
never extremes.
experienced any According to
trauma to research, providing
her eyes or head and the patient with
has foods rich in vitamins
never had any C, E, beta-carotene,
serious eye zinc, and copper
problems or surgery. improves her die
-Does not know of
any
family history of eye
problems.
Objective:
Distant Visual Acuity:
Right eye (OD) 20/40
Left eye (OS) 20/40
• No lid lag is noted.
• The extraocular
muscles
are intact.
• The visual fields are
equal.
• No excessive
tearing or
blinking is noted.
• The conjunctivae
are
smooth and without
redness.
• The pupils are
bilaterally
round, equal in size,
and
reactive to light and
accommodation.
• No nystagmus is
noted.
• Unable to assess
the red
reflex or perform an
ophthalmic
examination because
of the patient’s
bilateral opacities of
the
lens.
