NURSING CARE PTEREGIUM
1. Demographics Data
Include: name, age, sex, education, occupation and so on.
2. PolaFungsional
a.Persepsi health and health care
• Main complaints: Blurred vision
• Medical history:
-Since when perceived, how long
- Description of the symptoms of what is experienced, what worsen or improve?
-What to do to cure the symptoms.
• Use of current medications:
• Medical history first: history of trauma to the eye
• History of family illness: Families who have suffered
b.Pola activities: Activities little disturbed
cognitive c.Pola - Conceptual
-There was a sharp deterioration in vision, blurred vision
Physical Examination-eye:
• Conjunctiva
• visual acuity
3. Nursing Diagnosis may arise
Preoperatively
1. Sensory perceptual disorders associated with impaired sensory acceptance due pterigium.
Intervention:
- Determine the client's visual acuity, note whether one / two eyes are symptoms involved.
-Orient the client to the surrounding environment
-Put the items required client nearby
- Involve the client and others in the fulfillment of daily life activities
2. Anxiety related to lack of knowledge about invasive procedures (surgical) that will be implemented.
Intervention:
-Assess the level of anxiety
-Give an explanation of operating procedures that will be implemented
- Give moral support in the form of prayer and motivation to clients
Post surgery
1. Changes comfort (pain) related to tissue trauma secondary to corneal transplant surgery
-Assess the level of pain experienced by the client
Teach client-distraction method / relaxation
-Create a comfortable bed
- Collaboration with the medical team for providing analgesic
2. The risk of infection associated with the procedure (invasive) surgery.
Intervention:
-Monitor the bandage every 2-4 hours
- Discuss with the client about the importance of washing their hands before treating
-Use aseptic technique in the treatment of postoperative
- Give appropriate indication drugs such as eye drops.
3. The risk of injury (injury) associated with changes in visual acuity.
Intervention:
-Assess visual acuity
- Plan all denagn care clients, explain routine every day
-Maintain the goods in the same client
-Assist in activities according to the needs
-Suggest to use tools such sticks
- Maintain eye lid to increase protection
4. Changes in pesepsi sensory (perceptual) with respect to postoperative wound.
Intervention:
-Determine the visual acuity
-Orient the client on the environment, the staff, everyone else around
- Place the items that are often needed within the side that was not operated on
- Encourage clients to consume nutritious nutrients, such as fruits that are yellow, like papaya, carrots etc.
- Provide appropriate medication therapy
5. Lack of knowledge related to the lack of information about self-care and home management.
Intervention:
- Provide reinforcement careful vigilance associated with the placement of furniture etc.
- Provide a description of the condition of the disease, before and after the surgery
- Explain and teach regular maintenance at the nearest health care
- Involve the people closest to the client in carrying out activities of daily living.
1. Demographics Data
Include: name, age, sex, education, occupation and so on.
2. PolaFungsional
a.Persepsi health and health care
• Main complaints: Blurred vision
• Medical history:
-Since when perceived, how long
- Description of the symptoms of what is experienced, what worsen or improve?
-What to do to cure the symptoms.
• Use of current medications:
• Medical history first: history of trauma to the eye
• History of family illness: Families who have suffered
b.Pola activities: Activities little disturbed
cognitive c.Pola - Conceptual
-There was a sharp deterioration in vision, blurred vision
Physical Examination-eye:
• Conjunctiva
• visual acuity
3. Nursing Diagnosis may arise
Preoperatively
1. Sensory perceptual disorders associated with impaired sensory acceptance due pterigium.
Intervention:
- Determine the client's visual acuity, note whether one / two eyes are symptoms involved.
-Orient the client to the surrounding environment
-Put the items required client nearby
- Involve the client and others in the fulfillment of daily life activities
2. Anxiety related to lack of knowledge about invasive procedures (surgical) that will be implemented.
Intervention:
-Assess the level of anxiety
-Give an explanation of operating procedures that will be implemented
- Give moral support in the form of prayer and motivation to clients
Post surgery
1. Changes comfort (pain) related to tissue trauma secondary to corneal transplant surgery
-Assess the level of pain experienced by the client
Teach client-distraction method / relaxation
-Create a comfortable bed
- Collaboration with the medical team for providing analgesic
2. The risk of infection associated with the procedure (invasive) surgery.
Intervention:
-Monitor the bandage every 2-4 hours
- Discuss with the client about the importance of washing their hands before treating
-Use aseptic technique in the treatment of postoperative
- Give appropriate indication drugs such as eye drops.
3. The risk of injury (injury) associated with changes in visual acuity.
Intervention:
-Assess visual acuity
- Plan all denagn care clients, explain routine every day
-Maintain the goods in the same client
-Assist in activities according to the needs
-Suggest to use tools such sticks
- Maintain eye lid to increase protection
4. Changes in pesepsi sensory (perceptual) with respect to postoperative wound.
Intervention:
-Determine the visual acuity
-Orient the client on the environment, the staff, everyone else around
- Place the items that are often needed within the side that was not operated on
- Encourage clients to consume nutritious nutrients, such as fruits that are yellow, like papaya, carrots etc.
- Provide appropriate medication therapy
5. Lack of knowledge related to the lack of information about self-care and home management.
Intervention:
- Provide reinforcement careful vigilance associated with the placement of furniture etc.
- Provide a description of the condition of the disease, before and after the surgery
- Explain and teach regular maintenance at the nearest health care
- Involve the people closest to the client in carrying out activities of daily living.
REFERENCES
Medical Surgical I lecture materials, Banjarbaru
Doenges, Marilyn E. 1999. Nursing care plan. Edition 3. Publisher: EGC, Jakarta
Reeves, Charlene J - (ET ... al). , 2001. Medical Surgical Nursing. Publisher: Medika Salemba, Jakarta
