Question

Mr. Ellie Lee, a 74-year-old patient, is admitted to the hospital in the same-day surgery unit for nasal surgery. The patient is legally blind. The patient was diagnosed with a genetic disease, recessive retinitis pigmentosa (RP), which results in degeneration of the photoreceptor cells. A patient with RP has a progressive loss of visual acuity, progressive night blindness, and progressive loss of peripheral vision. The patient’s best corrected visual acuity is currently 20/200 with a visual field restriction of 12 degrees. The patient bumps into objects in the room and gets disoriented as to the location of the bathroom or the door to the hallway. What strategies should the nurse provide to help the client with low vision become oriented with the hospital room environment and to maintain as much independence with mobility as possible? What nursing considerations should the nurse make when providing peri-operative care?

Answer 1

Ans) Low vision:

- Visional impairment that requires devices and strategies in addition to corrective lenses.

- Best corrected visual acuity (BCVA) of 20/70 to 20/200

- Considered legally blind.

• Nursing consideration for client with low vision:

- Support coping strategies, grief processes, and acceptance of visual loss.

- Strategies for adaptation to the environment.

- Provide safe environment- Avoid keeping hazardous materials in room.

- Placement of items in room- don't move things around

- "Clock method" for trays-ex pizza at 2 oclock

- Communication strategies

- Collaboration with low vision specialist, occupational therapy, or other resources

- Braille or other methods for reading/communication
Use of service animals