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Student Nurses’ Community

NURSING CARE PLAN - Glaucoma


ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTION RATIONALE EVALUATION
SUBJECTIVE: Disturbed Increased After 8 hours of Independent Goal met, patient
visual intraocular nursing has
“Masakit ang mata Sensory pressure intervention the • Ascertain • Affects maintained
ko at napansin ko Perception r/t patient will type/degree of choice of current visual
na lumabo at Altered inadequate visual loss interventions field/acuity
ngkaron ng parang sensory drainage of • Participate in and patient’s without further
ulap ang paningin reception aqueous humor therapeutic future loss.
ko” (I am having from the regimen. expectations
pain around my anterior
eye and I also chamber of the • Maintain
noticed that my eye current visual
vision is getting field/acuity • Encourage • Although
blurred and cloudy) atrophy of the without expression of early
as verbalized by optic nerve further loss. feelings about intervention
the patient loss/possibility of can prevent
Disturbed loss of vision blindness,
visual Sensory patient faces
the possibility
OBJECTIVE: or may have
already
• Cloudy experienced
pupils partial or
• Sudden/persistent complete loss
severe pain or of vision.
pressure in and Although
around eye(s) vision loss
• Headache cannot be
• V/S taken as restored
follows (even with
treatment),
T: 37 ˚C further loss
P: 80 can be
R: 18 prevented
Student Nurses’ Community

BP: 110/ 80 • Recommend • Reduces


measures to safety
assist patient to hazards
manage visual related to
limitations, e.g., changes in
reducing clutter, visual
arranging fields/loss of
furniture out of vision and
travel path; papillary
turning head to accommodati
view subjects; on to
correcting for environmenta
dim light and l light
problems of
night vision

Collaborative

Assist with
administration of
medications as
indicated:

• Pilocarpine • These direct-


hydrochloride acting topical
myotic drugs
cause
pupillary
constriction,
facilitating the
outflow of
aqueous
humor and
lowering IOP
Student Nurses’ Community

• Timolol maleate
• Beta]-
blockers
decrease
formation of
aqueous
humor
without
changing
pupil size,
vision, or
accommodati
on

• Acetazolamide
• Carbonic
anhydrase
inhibitors
decrease the
rate of
production of
aqueous
humor

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