Monday, December 17, 2012

Nursing Care Plan for Retinal Detachment

Retinal detachment is the separation of the the retina from the choroid (the middle vascular coat of the eye between the retina and sclera). It occurs when the retina develops a hole or tear and the vitreous seeps between the retina and choroid. If left untreated, retinal detachment can lead vission loss.

The possible causes of retinal detachment are Trauma, Hemorrhage, Myopia, Tumor, Aging, Diabetic neovascularization, Inflammatory process and Familial tendency.

Assessment findings of retinal

detachment :
  • Painless change in vision (floaters caused by blood cells in the vitreous and flashes of light as the vitreous humor pulls on the retina).
  • Photopsia ( recurrent flashes of light).
  • Blurred vision worsening as detachment increases.
  • with progression of detachment, painless vision loss that may be described as veil, curtain or cobweb that eliminates part of the visual field.
Diagnostic evaluation for Retinal Detachment :
  • Indirect opthalmoscopy shows retinal tear or detachment.
  • Slit-lamp examination reveals retinal tear or detachment.
  • Ultrasound shows retinal tear or detachment in presence of cataract.
Treatment for Retinal Detachment :
  • Complete bed rest and restriction of eye movement to prevent further detachment.
  • Laser theraphy, if there's a hole in the posterior portion of the retina
  • Scleral buckling to reattach the retina, It is a surgical procedure, which a silicone band or sponge is sewn around the eyeball a little behind the visible portion or the eye. Exactly locates the hole and places the band and tightens it creating a buckle effect and then the outer coats of the eye are indented and in this way the hole in the retina approximates the outer scleral coat.

  • Pneumatic Retinopexy, It is a short simple procedure, where a fixed amount of air is injected in the posterior part of the eye, which the air acts as an internal tamponade that helping to push and approximate the tear with the outer coat of the eye ball. Following the tear is sealed with cryo or laser therapy. Post-operatively the patient is advised rest in a specified position, in order to facilitate the air bubble to push the desired area of the retina with the tear against the sclera.


  • Sub-retinal fluid drain : make seep the fluid out through the hole behind the retina that can be drained with a small slit made in the outer coats of the eye to flatten the retina. This procedure is usually done along with sclera bucking to flatten the retina.
  • Vitrectomy: The procedure involves cutting and removal of the vitreous gel along with removal of all the fibrous tissue causing traction (pull) on the retina and detaching it, or sometimes the space is replaced with gas or silicon oil. ussually the procedure is done with the help of micro instruments and a fiberoptic light source. The procedure is combined with sclera buckling.

  • Cyropexy, if there's a hole in the peripheral retina.

Nursing diagnoses for Retinal Detachment :
  • Disturbed sensory perception (visual).
  • Anxiety.
  • Risk for injury.
Planning and goals nursing care plan for Retinal Detachment :
  • The client will remain free from injury.
  • The client will be free from permanent visual impairment.
  • The client will understand the treatment options.
Implementation nursing care plan for Retinal Detachment :
  • Asses visual status and functional vision in the unaffected eye to determine self care needs.
  • Prepare the client for surgery by explaining possible surgical interventions and technique to alleviate some of the client's anxiety.
  • Discourage straining during defecation, bending down and hard coughing, sneezing or vomiting to avoid activities that increase intraocular pressure.
  • Assist with ambulation, as needed, to help the client remain independent.
  • Approach the clients from the unaffected side to avoid startling him.
  • Provide assistance with activities of daily living to minimize frustation adn strain.
  • Orient the client to his environment to reduce the risk of injury.
  • Posoperatively instruct the client to lie on his back or on his unoperated side to reduce intraocular pressure in the affected area.
Evaluation nursing care plan for Retinal Detachment :
  • The client's vision is restored.
  • The client will remains free from injury.
  • The client will understands all discharge instructions.

26 comments:

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Retinal examination ( ophthalmoscopy ): Your doctor may dilate your pupils and use a tool called an ophthalmoscope and to see the back of your eyes -- the retina, retinal blood vessels, fluid in your eyes (he may call this vitreous fluid), and the head of your optic nerve. ... You'll get drops to numb your eyes.

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(6) HPV
(7)EX BACK
(8)Tinnitus
(9) stroke
(10) asthma
(11) fibroid

I am from New York. I was in trouble when doctor told me that I have been
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DOCTOR EMMANUEL CAN AS WELL CURE THE FOLLOWING DISEASE:-
1. HIV/AIDS
2. HERPES
3. CANCER
4. ALS
5. DIABETES
6. HEPATITIS  

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Do you believe that Herpes has a permanent cure? My name is Vera White, I'm in Salt Lake City, Utah. I have been spending lots of money weekly on buying the popular Valtrex and sometimes Acyclovir, to suppress my Herpes outbreaks as prescribed to me in the hospital. Anyone who has herpes can attest this, with all the pains and embarrassing symptoms. Unfortunately, I have found out that those hospital recommended products are frequently not effective at taking care of the problem but rather make you spend all your money. DR.Vadi herbal remedy will get to the root of the cause and cure you completely rather than suppress outbreaks with medication. And you will be happier, healthier, and outbreak free. He also has herbal remedies that can cure HIV, HPV, hepatitis and so on. He is the greatest of all herbal healers. His email is doctorvadi@yahoo.com and his Whatsapp number:  +2348074133083. You can contact him and get a permanent cure to your genital and oral Herpes or HIV AIDS or Lungs cancer or Alzheimer's disease.

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Dr. Riaria cured my herpes virus that have been in my body since two years, ever since then my life has been incomplete, I have used so many drugs that was prescribed to me by doctors, but it didn't cure my herpes virus, i was checking for solution on the internet then I miraculously came across Dr. Riaria the powerful herbalist that  can cure herpes infection, then I contacted him through his email, I explained everything to him and he prepared a herbal medicine and sent it to me through FedEx, which I took for 14 days with the instruction he gave me, and when I did a test in the hospital my result came out negative it was the happiest day of my life that am cure from HSV 2,  are you also suffering from same virus or another diseases you can simply contact him via email: drriaria@gmail.com  you can also call or WhatsApp him on: +2349134987375.  

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Thanks to Dr osaze who cured me of fallopian tube blockage and fibroid that rendered me childless for seven years with his wonderful herbal medication, at last I now have a child of my own, you can also contact him on his email on drosazeherbal@gmail.com or whatsap him on +2347089275769.

HOW I GOT MY HUSBAND BACK WITH THE HELP OF DOCTOR OYAMA CONTACT ON WHATS_APP NUMBER +2348108264684

This is my testimony about the good work of  Oyama who helped me.... I'm Treesha Gaona from New York. And am sorry for putting this on net but i will have to, by this world best spell caster that brought back my husband who left me out for past 3 years, i eventually meet this man on a blog site posting by one of is client for help, i explained everything to him and he told me about a spell caster that he had heard about and he gave me an email address to write to the spell caster to tell him my problems. In just 1 days, my husband was back to me. I just want to say thank you to this truthful and sincere spell caster, sir all you told me have come to pass and thank you sir. Please I want to tell everyone who is looking for any solution to their problem, I advise you to kindly consult this spell caster, he is real, he is powerful and whatever the spell caster tells is what will happen, because all what the spell caster told me came to pass. You can kindly contact him on: his email address is droyamasolutiontemple@gmail.com or directly on WhatsApp +2348108264684

WHAT A GREAT MIRACLE THAT I HAVE EVER SEE IN MY LIFE. My names are Clara David I’m a citizen of USA, My younger sister was sicking of breast cancer and her name is Sandra David I and my family have taking her to all kind of hospital in USA still yet no good result. I decided to search for cancer cure so that was how I found a lady called Peter Lizzy. She was testifying to the world about the goodness of a herbal man who has the roots and herbs to cure all kinds of disease and the herbal man's email was there. So I decided to contact the herbal man @herbalist_sakura for my younger sister's help to cure her breast cancer. I contacted him and told him my problem he told me that I should not worry that my sister cancer will be cure, he told me that there is a medicine that he is going to give me that I will cook it and give it to my sister to drink for one week, so I ask how can I receive the cure that I am in USA, he told me That I will pay for the delivery service. The courier service can transport it to me so he told me the amount I will pay, so my dad paid for the delivery fee. two days later I receive the cure from the courier service so I used it as the herbal man instructed me to, before the week complete my sister cancer was healed and it was like a dream to me not knowing that it was physical I and my family were very happy about the miracle of Doctor so my dad wanted to pay him 5 million us dollars the herbal man did not accept the offer from my dad, but I don't know why he didn't accept the offer, he only say that I should tell the world about him and his miracle he perform so am now here to tell the world about him if you or your relative is having any kind of disease that you can't get from the hospital please contact dr.sakuraspellalter@gmail.com or WhatsApp him +2348110114739 visit his website https://www.instagram.com/herbalist_sakurahttps://web.facebook.com/herbalistsakura/ https://drsakurahealthclinic.wixsite.com/website https://sites.google.com/view/herbalistsakura https://drsakuraspellcentre.blogspot.com/ https://drsakuraspellcentre.wordpress.com/ for the cure, he will help you out with the problem. And if you need more information about the doctor you can mail me davidclara223@gmail.com

I started on COPD Herbal treatment from Ultimate Life Clinic, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Life Clinic via their website at www.ultimatelifeclinic.com I can breath much better and It feels comfortable!

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I am out today to let the world know about this great man from Africa he is a good man and his spell work 💯 % according to your heart desire contacts him today and get your problem Solved because when I contacted him I thought it won't work but at last am with my husband today and with my kids all thanks to Dr Okosun you are indeed a great man God bless you' you can contact him via what's app +2348133974847 or Okosunspelltemple33@gmail.com

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