CATARACTS (Rationale):

1. ANSWER C. A gradual, painless blurring of central vision is the chief

clinical manifestation of a cataract. Early symptoms include slightly
blurred vision and a decrease in color perception.
2. ANSWER C. The most appropriate nursing diagnosis for the client
scheduled for cataract surgery is Disturbed sensory perception
(visual) related to lens extraction and replacement. Although the
other options identify nursing diagnoses that may be appropriate,
they are not related specifically to cataract surgery.
3. ANSWER C. A mydriatic medication produces mydriasis or dilation
of the pupil. Mydriatic medications are used preoperatively in the
cataract client. These medication act by dilating the pupils. They
also constrict blood vessels. An osmotic diuretic may be used to
decrease intraocular pressure. A miotic medication constricts the
pupil. A thiazide diuretic is not likely to be prescribed for a client
with a cataract.
4. ANSWER A. Severe pain or pain accompanied by nausea is an
indicator of increased intraocular pressure and should be reported to
the physician immediately. The other options are inappropriate.
5. ANSWER C. The client is instructed to wear a metal or plastic shield
to protect the eye from accidental and is instructed not to rub the
eye. Glasses may be worn during the day. Aspirin or medications
containing aspirin are not to be administered or taken by the client
and the client is instructed to take acetaminophen as needed for
pain. The client is instructed not to sleep on the side of the body on
which the operation occurred. The client is not to lift more than 5
pounds.
6. ANSWER D. Surgical removal is the only treatment used at this
time for cataracts; no medical treatment is available to prevent or
treat them. Surgical removal of the cataract and lens is indicated
when the cataract has developed to the point that vision and
activities of daily living are affected. If the patient presents with
bilateral cataracts, surgery is only performed on one eye at a time.
Complications from cataract surgery are unusual, and occur in less
than 1% of the surgeries.
7. ANSWER C. The nurse should reinforce any limitation, such as
avoiding reading, lifting, and strenuous activity, and sleeping on the
operative side. The patient also needs to understand the importance
of not disturbing the eye dressing, of follow-up appointments, and of
manifestations of complications such as eye pain, change in vision,
headache, or nausea.

8. ANSWER D. Prolonged use of steroidal anti-inflammatory agents is

a risk factor for cataracts. The other risk factors dont contribute to
the development of cataracts.
9. ANSWER B. Pain shouldnt be present after cataract surgery. The
client should be told the other symptoms might be present.
10.
ANSWER D. The client should report a noticeable or sudden
decrease in vision to the physician. The eye may be slightly
reddened postoperatively, but this should gradually resolve. The
client is taught to take acetaminophen, which is usually effective for
relieving discomfort. Small amounts of dried material may be
present on the lashes after sleep; this is expected and should be
removed with a warm facecloth.