Question

A nurse at the local Senior Center made the following notation about a client: A 74-year-old female client wearing eyeglasses with bifocal lenses and hearing aid in her left ear. Walks with a shuffling gait, using a cane for support. Wearing house slippers and housedress. States, "My other doctor says I should have my eyes looked at by an expert. It's been a while, and my eyes seem to be acting up lately. I can't see so good anymore." The client states that she takes medication for "sugar" and her blood pressure and has worn glasses for years with the last prescription changed about 3 years ago. "I was a seamstress for many years and quit when I couldn't see to thread the needles anymore-just in time too. These new materials are too hard to work with!" Denies using any eye drops. Describes vision changes as difficulty seeing well at night, especially if trying to read. Uses a magnifying glass to help when reading. No eye pain or discharge, although eyes sometimes feel "dry and scratchy," with the left eye being worse than the right. Admits to rubbing eyes but without relief.

Develop a Plan of Care for this patient that includes:

2 Nursing Diagnosis

2 goals for each Nursing Diagnosis

Interventions with rationales

Answer 1

ANSWER

    * Two nursing diagnosis

             * Ineffective coping related to systemic diseases and eye problems.

             * Anxiety related to visual impairment.

* Two goals for each nursing diagnosis.

             * Ineffective coping related to systemic diseases and eye problems.

                           Goals.

                                * Make the patient cope up with the health condition.

                              * Enhance self esteem of the patient.

                       Interventions with rationale

                                * Provide real informations about current health status,treatment and prognosis

                                  which help to explore her feeling and make a final decision about how to cope up

                                  the condition.

                                * Promote to express her feelings,emotions and fears about the health problems

                                  to solve it by counselling sessions.

                                * Encourage participation of family members in care of her which help to increase

                                   confidence level of the pat

               * Anxiety related to visual impairment.

                               Goals.

                                     * Reduce the anxiety level of the patient.

                                     * Provide a good therapeutic environment.

                             Intervention and rationale

                                  * Provide psychological support to reduce the stress level.

                                  * Give a peaceful environment to reduce the anxiety level.

                                * Be a good listener and keep trustful relationship with patient by communication

                                    to decrease the anxiety level.