2 Cataracts Nursing Care Plans

Disturbed Sensory Perception: Visual

Disturbed sensory perception: visual is a common issue for patients with cataracts due to several factors. Firstly, cataracts can cause poor visual acuity and decreased contrast sensitivity, leading to blurred or distorted vision. Secondly, changes in the eyes due to aging, such as a decrease in the transparency of the lens, can contribute to the development of cataracts and further impair visual function. As a result, patients with cataracts may experience a range of visual disturbances that can impact their ability to perform activities of daily living and negatively impact their quality of life.

Nursing Diagnosis

• Disturbed Sensory Perception

May be related to

• Cataracts
• Poor visual acuity
• Changes in the eyes due to aging

Possibly evidenced by

• Visual distortions
• Loss of vision
• Diminished visual acuity
• Photophobia
• Night blindness
• Myopia
• Presbyopia
• Accommodation changes
• Changes in usual response to stimuli
• Presence of cataract

Desired Outcomes

• The patient will regain the optimal vision possible and will adapt to permanent visual changes
• The patient will be able to verbalize understanding of visual loss and diseases of the eyes.
• The patient will be able to regain vision to the maximum possible extent with the surgical procedure.
• The patient will be able to deal with the potential for permanent visual loss.
• The patient will maintain a safe environment with no injury noted.
• The patient will be able to use adaptive devices to compensate for visual loss.
• The patient will be compliant with the instructions given and will be able to notify the physician of emergency symptoms.

Nursing Assessment and Rationales

1. Assess the patient’s ability to see and perform activities.
Provides a baseline for the determination of changes affecting the patient’s visual acuity.

Nursing Interventions and Rationales

1. Encourage the patient to see an ophthalmologist at least yearly.
Can monitor progressive visual loss or complications. Decreases in visual acuity can increase confusion in elderly patients.

2. Provide sufficient lighting for the patient to carry out activities.
Elderly patients need twice as much light as younger people.

3. Provide lighting that avoids glare on surfaces of walls, reading materials, and so forth.
Elderly patients’ eyes are more sensitive to glare and cataracts diffuse glare so the patient has more difficulty with vision.

4. Provide night light for the patient’s room and ensure lighting is adequate for the patient’s needs.
Patients’ eyes may require longer accommodation time to changes in lighting levels. The provision of adequate lighting helps to prevent injury.

5. Prepare the patient for cataract surgery as warranted.
Provides knowledge, and facilitates compliance with the regimen.

6. Instruct patient regarding normal age-related vision changes, cataracts, and methods of dealing with visual acuity changes.
Helps increase the patient’s understanding of visual changes and to make informed choices about options as the patient ages, the lens becomes denser and has less elasticity thus accommodation is decreased. Presbyopia is an age-related change that begins in people who are in their 40s and progresses. Visual acuity changes occur as the eye becomes more hyperopic as a result of neurologic changes in the visual pathways of the brain. The ability to distinguish fine details decreases because of the loss of neurons in the visual pathways in the brain.

Vitreous humor changes related to aging occur and consist of haziness, vertical flashing lights, line spots, or clusters of moving dots. The ability to differentiate colors also decreases with age because the cones that are responsible for color vision decline in sensitivity. In patients over 60, the lens may become yellowed from age, which results in blue objects appearing gray. Visual field decreases by approximately 1-3 inches per decade after 50.

7. Provide large print objects and visual aids for teaching.
Assists patient to see larger print and promotes a sense of independence.

8. If surgery is planned, instruct the patient and/or family regarding the procedure, post-procedure care, and the need for follow-up with the physician. Instruct about complications and emergency signs and symptoms (flashing lights with loss of vision, seeing a “veil” falling over the visual field, loss of vision in a specific portion of the visual field, etc.) of which to notify the physician.
Prepares the patient for what to expect, facilitates compliance and provides instruction about potential problems to lessen anxiety.