Improper drainage dt trabecular meshwork being clogged which causes damage to

Improper drainage dt trabecular meshwork being

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Improper drainage d/t trabecular meshwork being clogged which causes damage to the ocular nerve Angle closure (narrowed angle) glaucoma Angle is closed and doesn’t allow it to drain MEDICAL EMERGENCY; increased intraocular pressure increases very quickly If not treated immediately they will be blind Symptoms Usually asymptomatic until there is loss of vision Halos around lights Blurred vision Difficulty in focusing Loss of peripheral vision (1 st signs) Aching or discomfort around the eyes or HA are late signs Diagnostic testing: tonometry; funduscopy; gonioscopy; visual field testing DON’T WORRY ABOUT THE DIAGNOSTICS FOR EYE/EAR Intraocular Pressure 5
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NURS400: Chp. 58,59,60,61,64,65,12 Exam #6 Loss of Peripheral Vision with Open-Angle Glaucoma GLAUCOMA: COLLABORATIVE CARE 6
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NURS400: Chp. 58,59,60,61,64,65,12 Exam #6 Medications are treatment of choice: to control IOP and prevent optic nerve damage; usually lifelong therapy; cannot be cured, just controlled Table 58-4 **KNOW MEDS** Beta blockers (topical – 1 st preferred treatment) (-LOL) MOA: Decreases aqueous humor production S/E: Bradycardia Hypotension Asthma and COPD patients cannot receive Beta Blockers d/t it causing severe respiratory problems Contraindicated for HF and 2 nd or 3 rd degree Heart Block If they have Bradycardia → you need to block the lacrimal sac (punctal occlusion)to prevent systemic absorption Cholinergics (Miotics, Pilocarpine, Carbachol) MOA: Increases aqueous humor OUTFLOW S/E: Periorbital Pain Blurred Vision Difficulty seeing in the Dark CAUTION PATIENTS ABOUT DIMINISHED VISION IN DIMLY LIT AREAS Adrenergic agonists (Dipivefrin, Epinephrine) (-RIN, -RINE) MOA: Reduces the production of aqueous humor & increases outflow S/E: Eye Redness & Burning Systemic Effects: Anxiety Palpitations HA Increased B/P Alpha-adrenergic agonists (Apraclonidine, Brimonidine) (- ONIDINE) MOA: Increase aqueous humor outflow decreases aqueous humor production S/E: Eye Redness Dry Mouth and Nasal Passages Use Punctal Occlusion when administering Carbonic anhydrase inhibitors (Acetazamide, Methaeolamide, Dorzolomide) (-MIDE) MOA: decreases production of aqueous humor and decrease intraocular pressure S/E: Anaphylactic Rx Electrolyte loss 7
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NURS400: Chp. 58,59,60,61,64,65,12 Exam #6 Lethargy GI Impotence Weight loss (PO) DO NOT ADMINISTER WITH SULPHA ALLERGIES MONITOR ELECTROLYTE LEVELS Prostaglandin analogs (Lantanoprost, Bimatoprost) (-PROST) MOA: Increases aqueous humor outflow S/E: DARKENING OF THE IRIS Conjunctival Redness Possible Rash ADMINISTERING EYE DROPS (PG. 1773) Apply pressure on the inner canthus for 1-2 minutes after instilling drops Wait 5-10 minutes before instilling another eye drop medication Surgery: trabeculoplasty; trabeculectomy; gonioplasty; laser iridotomy; peripheral iridectomy PURPOSE IS TO INCREASE DRAINAGE OF AQUEOUS HUMOR AND DECREASE INTRAOCULAR PRESSURE Glaucoma: Nursing Management Diagnoses: Disturbed Sensory Perception: Visual 8
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NURS400: Chp. 58,59,60,61,64,65,12
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