Reference no: EM133850508

Mr. Evans is a 73-year-old man who presents to the clinic with complaints of "foggy" vision, headaches, and aching in his eyes. He also reports seeing "rings around lights." Since his wife's death two months ago, he states things have not been going well at home. He has not been able to handle the bill payments because of his change in vision and his depression. He is upset and is worried that he will not be able to stay in his home. His children live in another state and have not been home to help him. Mr. Evans's vital signs are temperature 98.18F, blood pressure 172/92, pulse 68, and respiratory rate of 24. Tonometry shows an elevated intraocular pressure of 26 mm Hg. He reports that his peripheral vision is decreased and it is noted in the visual exam by the physician that his optic disk appears pale and the depth and size of the optic cup appears increased. Mr. Evans's history reveals that his mother also had glaucoma. His neighbor and good friend is with him and states, "I take care of Mr. Evans and drive for him." His diabetes is under control and he states, "If I keep good track of my diet and blood sugars, the only medication I need is my morning diabetic pill." He also talks openly about how depressed he has been since his wife died.

Questions

1. Define glaucoma and the group of conditions that can cause it.

2. Describe the tonometry test and normal results. What other tests can be used in diagnostics?

3. What symptoms would be found with acute angle-closure glaucoma?

4. The medical diagnosis for Mr. Evans is primary open-angle glaucoma. What are the clues in the case study that support this diagnosis?

5.  What risk factors does Mr. Evans have that contribute to glaucoma?

6. Discuss the pharmaceutical management for glaucoma. Discuss teaching Mr. Evans about these medications.

7. Mr. Evans has surgical management with a laser trabeculoplasty after failure of nonsurgical management. What is laser trabeculoplasty? What would be further management if he failed to respond to the laser therapy?

8. List three priority nursing diagnoses for Mr. Evans.

9. Mr. Evans has many worries about his ability to manage at home. What are main primary nursing foci for an older adult with impaired vision? 10. What types of services would help him to remain in his own home?