Assessment
Subjective data: The patient is Jessica, 32 years old woman who has a vision loss in her left eye. She states that she had no previous traumas or injuries. She also did not tear the eye or use any chemicals. Her eye vision started to worsen since this morning. She had a previous symptom of blurriness one month ago, but it improved with getting into a cool environment. She is healthy, does not use drugs, drinks occasionally. As of now, the main issue is that she has pain when moving her eye, and she also cannot determine colors. She claims that she has no other serious symptoms.
Objective data: The patient is nervous. BP 135/85 mm Hg; HR 64bpm and regular, RR 16 per minute, T: 98.5F. Visual acuity in the left eye is 20/200. Sclera white, conjunctivae clear. Unable to assess visual fields on the left side. Pupil response to light is diminished on the left eye. The optic disc is swollen. Full range of motions, no swelling or deformity.
Diagnosis
According to her words, Jessica’s first manifestation of eye’s disease in a form of blurriness happened as the outcome of overheating. It can be an Uhthoff’s Phenomenon or a sign of multiple sclerosis. Martin, T. & Corbett, J. (2013, p. 5) states that “increased body temperature from a hot shower or sauna may cause blurring of vision in patients who have had optic neuritis.” Wang et al. (2013) emphasize that optic neuritis affects young people between 18 to 45 years and can be predicted seeing a presence of the white matter lesions on the MRI.
Planning
Optic neuritis is caused by an inflammation of the optical nerve. In order to confirm the diagnosis, the patient should pass several medical tests. According to Toosy, Mason & Miller (2014), investigation for optical neuritis may include the MRI, visual evoked potential, CFS examination. If the reason of vision’s loss lies in multiple sclerosis, then the patient should also pass the MRI or the spinal fluid analysis. After completing with the initial check, the patient should be accompanied by the nurse for appointed procedures. With getting the results, a patient should meet his doctor to discuss the illness, possible treatment options, and further complications.
Intervention
The first task of the nurse is to identify pain, its patterns, and location. After getting this information, she should collaborate with other specialists in order to organize a management plan. The nurse is obliged to help the patient in her process of examination and recovery. She also must assist the patient in her daily activities. For minimizing patient’s stress, the nurse must explain all the required procedures and offer emotional support when dealing with consequences of the illness. Thus, she also must focus on a safety of the patient when applying eye patches or provide eye medication.
Evaluation and Teaching Plan
The main aim of this step to support and teach the customer about illness, treatment options, the nature of pain and its remedies, and future lifestyle changes. For this, the nurse can develop a teaching plan that will use specific techniques and tools, which can be easily interpreted by the patient and her relatives. The main aim of evaluation is to provide confidence and knowledge that stress will be an additional factor that can worsen the situation.
References
Karussis, D. (2014). The diagnosis of multiple sclerosis and the various related demyelinating syndromes: a critical review. Journal of autoimmunity, 48, 134-142.
Martin, T. & Corbett, J. (2013). Practical neuroophthalmology. Columbus, OH: McGraw-Hill Education.
Toosy, A. T., Mason, D. F., & Miller, D. H. (2014). Optic neuritis. The Lancet Neurology, 13(1), 83-99.
Wang, I. H., Lin, S. Y., Woung, L. C., Shih, Y. F., & Jou, J. R. (2013). Clinical prospective study of visual function in patients with acute optic neuritis. Journal of the Formosan Medical Association, 112(2), 87-92.