NURSING CARE RELATED TO THE SENSORY AND
NEUROLOGICAL SYSTEMS
1-22
1-22. POSTOPERATIVE NURSING CARE OF THE PATIENT UNDERGOING OPHTHALMIC SURGERY
a. Return from Surgery.
(1) The patient must be lifted off the litter, he is not to move himself.
(2) The patient should be positioned in the bed as prescribed by the physician.
(3) Sandbags should be used to immobilize the patient's head, if ordered.
(4) If both eyes are bandaged (they normally are), the side rails MUST be raised at all times to protect the patient in the event he becomes disoriented and attempts to get out of bed.
(5) Place the call bell within easy reach of the patient's head and let the patient know exactly where it is located.
(6) Remind the patient that he should not cough, sneeze, or blow his nose. Instruct him to inform the staff if he feels the urge, since these actions will increase intraocular pressure.
b. Orientation.
(1) Reinforce the physical orientation given during the preoperative period by verbally reviewing the locations of objects in the room.
(2) Orient the patient to other people in the room.
(3) The patient should have an awareness of his surroundings and know what to expect to avoid being startled or frightened.
c. Precautions.
(1) Avoid dislodgement of the eye dressings by securing them with an eye shield or reinforcing loose tape.
(2) Restrain the arms of children and disoriented or uncooperative patients, as appropriate.
(3) A sleeping patient must be watched constantly to ensure that proper positioning is maintained. Often, a family member may be asked to stay with the patient for this purpose.
(4) Avoid jarring or bumping the bed, as this may startle the patient.
(5) If the patient is newly blinded as a result of the surgery, observe for depression and take precautions if patient is potentially suicidal.
(6) Check the physician's orders before giving anything by mouth. Nausea and vomiting must be avoided. Additionally, the motion of chewing may be contraindicated.
d. Approaching the Patient. An important consideration in the care of a patient who has both eyes bandaged is the method of approaching him.
(1) ALWAYS speak to the patient upon entering his area and before touching him.
(2) Allay the patient's fears by explaining each procedure or activity fully.
(3) Continue to reinforce his orientation to the surroundings.
(4) Always let the patient know when you are leaving his area.
e. Diversional Activity. Diversional activities will promote a relaxed atmosphere for convalescence and prevent the patient from dwelling on his situation.
(1) Provide activities that are not fatiguing to the eyes if the eyes are not bandaged.
(a) No reading.
(b) Minimal television.
(2) Encourage visitors to chat with the patient or read to him.
(3) Encourage the use of a radio for entertainment and to keep the patient "in touch" with current events if he is unable to read the daily newspaper.
