Nursing Care Plan (NCP) for Glaucoma

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Outline

Pathophysiology

Glaucoma is a group of eye conditions that damage the optic nerve, the health of which is vital for good vision. This damage is often caused by an abnormally high pressure in your eye. Two kinds of glaucoma are open-angle and angle-closure. Glaucoma is one of the leading causes of blindness for people over the age of 60. It can occur at any age but is more common in older adults.

Etiology

The exact cause of glaucoma is unknown.  As far as the most common type of glaucoma, open-angle, the theory is that the drainage system of the eye becomes insufficient over time and subsequent pressure builds up.

Age (over 60), race, genetics/family history, eye injury, other eye pathology, as well as corticosteroid use are all risk factors for glaucoma.

Desired Outcome

Decrease intraocular pressure as quickly as possible, prevent further visual damage.

Glaucoma Nursing Care Plan

Subjective Data:

  • Hazy vision
  • Rainbow-colored halos around lights 
  • Sudden vision loss
  • Severe eye pain/pressure
  • Slow vision changes (blurred vision, narrowed vision (tunnel vision), blind spots 
  • Nausea

Objective Data:

  • Vomiting

Nursing Interventions and Rationales

Nursing Intervention (ADPIE) Rationale
Assess patients vision  knowing where the patients vision was previous to what you assess currently so you know how much their vision has changed from before 
Educating on proper eye drop administration  Post-procedure or during long-term management, patients are frequently on various eye drops. It’s essential they understand thoroughly which drops to administer when, how to do so appropriately. They may need additional intervention with color-coding bottles because they may not be able to clearly read labels. Ensure support systems are equally aware of regimen.
Educate on importance of F/U care with provider  Compliance is key! Patients must follow be compliant with their treatment regimen to prevent further deterioration.

Also to immediately report any new changes that may happen 

Manage pain  Patients can have sudden pain, which will increase their intraocular pressure, making the problem even worse.
Manage anxiety  A sudden inability to see or the new knowledge that you will have a degree of blindness is upsetting. Provide as much education and emotional support as possible, and if necessary, administer medications.

Writing a Nursing Care Plan (NCP) for Glaucoma

A Nursing Care Plan (NCP) for Glaucoma starts when at patient admission and documents all activities and changes in the patient’s condition. The goal of an NCP is to create a treatment plan that is specific to the patient. They should be anchored in evidence-based practices and accurately record existing data and identify potential needs or risks.

 

References

https://www.mayoclinic.org/diseases-conditions/glaucoma/symptoms-causes/syc-20372839

https://my.clevelandclinic.org/health/diseases/4212-glaucoma

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Transcript

Hey guys. Today, we are going to be creating a nursing care plan for glaucoma. So let’s get started. We’re going to first go over the pathophysiology of glaucoma. It’s a group of eye conditions that damage the optic nerve – the health of that is vital for good vision. Nursing considerations: You want to assess a patient’s vision, educate on eyedrop, use, follow-up care and compliance in managing the patient’s pain and anxiety. Desired outcome: you want to decrease intraocular pressure as quickly as possible and prevent further visual damage. 

So we’re going to go into our care plan. We’re going to be looking for some subjective data and some objective data that you’re going to see in your patient. So one of the main things you’re going to see are vision changes. So vision changes that you’re going to have, or the patient will state that they have a sort of blurred vision, narrowed vision, or what they call tunneled vision and blind spots. The patient can also have some nausea and vomiting. Some interventions that we’re going to be looking for are going to want to assess the patient’s vision and assess their eyes. Is that a little pretty eye? So you want to look into their eyes. You want to know where the patient’s vision was previous to having come in to see the physician, and you want to see how much that’s changed since the last time that they were in. 

Another thing that we’re going to be doing is we want to educate on proper eye drop use and administration. So eyedrops: with eye drops, you want to make sure whether it was post-procedure or during long-term management, that the patient is administering in different eyes. So you want to make sure that they understand which eye drops they’re to be administering, when, and how to do so appropriately. They’ll need additional interventions with color cording bottles, especially if they’re not able to read the labels clearly. So ensure support systems are equally aware of this regimen to make sure that they are giving drops properly. One of the things to keep in mind with the eyedrops is making sure that they’re not touching the eye when they administer and making sure that they have washed their hands properly prior to administering the drops. 

Next intervention that we’re going to look into is the importance of education on follow-up care. So follow-up with the provider; it is very, very important that we’re making sure that these patients are complying with using the medications as needed, like the eye drops. So you want to make sure that they’re keeping with that compliance because unfortunately, if they don’t, it can make the condition much worse. 

Another thing we’re going to want to do is manage pain. Patients can have sudden pain, which will increase their intraocular pressure. So making this a priority for them will just help decrease pressure. Another intervention that we’re going to want to make sure that we’re doing is easing their anxiety. With these patients, having that sudden inability to see things properly or having a certain degree of blindness, can be very, very upsetting. So you want to provide as much education and emotional support as possible and if necessary administer any sort of medications. Okay? 

So we’re going to go over some key points. For pathophysiology: it is a group of eye conditions that damage the optic nerve. The exact cause is unknown, but many causes do include a buildup of drainage in a system that becomes insufficient, genetics, family history, or any sort of eye injury. Any subjective or objective that you’re going to see with the patient: they’re going to have hazy vision, rainbow colored, halos, and lights, sudden vision loss (which is very common), severe eye pain, pressure, vision changes, and nausea and vomiting. You want to make sure you’re assessing the patient’s eye and doing plenty of education. So you want to assess their vision. You want to make sure you’re educating them on the eye drop usage and educate them on the importance of follow-up and compliance with the medication. You want to make sure that these patients are using these eye drops accordingly, because otherwise it can make their condition worse and can cause blindness. You want to manage pain. You want to manage anxiety. So administer pain medication as needed and provide as much emotional support for these patients as possible. And, if needed, administer medication for the anxiety. 

Awesome job, it was a great care plan for today. We love you guys. Go out, be your best self today and as always happy nursing.

 

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