Assessment
Subjective
The patient is a 32-year-old female, who suffers from a sudden decrease in vision in the left eye. Traumas, injuries, tearing, redness, or exposure to any chemicals are defined. The case of blurring of vision was observed one month ago, but it was explained as the outcome of overheating. On the morning of the day the patient addresses the ER, the patient woke up with her left eye already sick, and the decrease of vision has progressively worsened.
Objective
The patient is alert and anxious. Still, she looks normally healthy. T: 98.5F, BP 135/85 mm Hg, HR 64 bpm and regular, RP 16 per minute. The optic disc is swollen. The patient feels pain if she moves her left eye and cannot determine colors by the eye that has poor vision.
Nursing Diagnosis
The loss of central vision is one of the frequently discussed problems among many young adults (Chan, 2014). Regarding the information given by the patient such as her inabilities to determine colors, eye movement pain, and sudden decrease of vision in one eye, the threat of optic neuritis can be diagnosed. It is necessary to consider that multiple sclerosis can be another risk for people with optic neuritis (Malik et al., 2014). Still, the patient informs that she is a math teacher with a bachelor’s degree in Math and a master’s degree in education. Such an educational experience and achievement should deny the possible signs of sclerosis.
Planning
After 30 minutes of nursing intervention, the patient should visit the specialist and check if it is necessary to take more tests or analyses. It is necessary to follow if the customer stays in peace and calm because optic neuritis may be characterized by some complications in case the patient continues nerving and cannot cope with anxiety. However, only 4% of patients are characterized by prolonged administration of the disease (Kronig, Vaudaux, Suva, Lew, & Uckay, 2015). As soon as the diagnosis is approved by the doctor, the patient should be informed about possible further activities, disease treatment, and the regimen that should be followed. As a rule, optic neuritis is not a complicated disease and may get well on its own soon in case the patient follow the prescriptions.
Intervention
There are several steps to be taken by a nurse:
- To develop trustful relations with the patient;
- To help the patient cope with her anxiety and other doubts;
- To support in movements in case she is not confident in her actions;
- To check the patient’s blood pressure again;
- To offer a special protecting bandage on the eye so that the patient does not feel pain in eye movement;
- To encourage the patient that the disease is not dangerous, and peace and comfort are the two main treatment methods.
Evaluation and Teaching Plan
The patient has to be provided with clear information about the reasons why she may suffer from a sudden decrease of vision in her eye. After several hours of nursing intervention, the patient is able to explain the disease and the peculiarities of treatment that can be offered. The patient should also understand that the psychological and emotional conditions are important in this case, and there should be no place for anxiety. Comfort and rest are the best solutions, and the improvements can be observed in a short period of time.
References
Chan, J.W. (2014). Optic nerve disorders: Diagnosis and management. New York, NY: Springer.
Kronig, I., Vaudaux, P., Suva, D., Lew, D., & Uckay, I. (2015). Acute and chronic osteomyelitis. In D. Schlossberg (Ed.), Clinical Infectious Disease (p.448 – 453). Cambridge, UK: Cambridge University Press.
Malik, M. T., Healy, B. C., Benson, L. A., Kivisakk, P., Musallam, A., Weiner, H. L., & Chitnis, T. (2014). Factors associated with recovery from acute optic neuritis in patients with multiple sclerosis. Neurology, 82(24), 2173-2179.