CLIENT PROFILE: 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. CASE STUDY: Mr. Evans’s vital signs are temperature 98.18F, blood pressure 172/92, pulse 68, and respiratory rate of 24. Tonometry
CLIENT PROFILE:
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.
CASE STUDY:
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 exams 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:
3. What risk factors does Mr. Evans have that contribute to glaucoma?
4. Discuss the pharmaceutical management for glaucoma. Discuss teaching Mr. Evans about these medications.
5. Evans has many worries about his ability to manage at home. What are main primary nursing foci for an older adult with impaired vision? What types of services would help him to remain in his own home?
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