Nursing Interventions for Acute Pain and Disturbed Sensory Perception - NCP for Glaucoma

Nursing Care Plan for Glaucoma

1. Nursing Diagnosis : Acute Pain
Limitation of characteristics:
a. Changes in appetite
b. Changes in blood pressure
c. Changes in heart rate
d. Changes in respiratory frequency
e. Sleep problems
f. Pupillary dilation

NOC

Comfort Level
Indicator:
a. Reporting physical condition improved
b. Report satisfaction with pain control
c. Demonstrate satisfaction with pain control

Pain Control
Indicator:
a. Patients know of pain attacks
b. Patients know the symptoms of pain
c. Using preventive measures

Pain disruptive effect
Indicator:
a. Patients report loss of sleep disturbance
b. Loss of appetite

Pain level
Indicator:
a. Pain complaints
b. Facial expression against pain

NIC

Pain Management

1. Perform a comprehensive pain assessment starting from the location, characteristics, frequency, quality, intensity, and causes
2. Determine the impact of pain on daily life (sleep, appetite)
3. Determine the level of needs of patients who can provide comfort to patients and nursing plans
4. Provides information about pain, an example of the cause of pain, how it occurs, anticipates discomfort
5. Provides analgesics needed in dealing with pain
6. Encourage adequate rest / sleep to reduce pain
7. Encourage patients to discuss experiences with pain
8. Providing adequate information to increase family knowledge of the patient
9. Include family in developing methods of dealing with pain
10. Monitor client satisfaction with the management provided in defined intervals

2. Nursing Diagnosis : Disturbed Sensory Perception: vision
Limitation of characteristics:
a. Changes in sensory sharpness
b. Changes in the general response to stimuli
c. Failed adjustment
d. Sensory distortion

NOC
Anxiety Control:
Indicator:
a. Monitor the intensity of anxiety
b. Eliminating triggers for anxiety
c. Reducing environmental stimuli when anxious
d. Looking for information to reduce anxiety
e. Plan coping strategies for pressing situations
f. Use effective coping strategies
g. Use relaxation techniques to reduce anxiety
h. Maintain social relations
i. Report the absence of perceptual aberrations
j. Reporting the absence of physical manifestations of anxiety

Vision Behavior Compensation:
Indicator:
a. Monitor symptoms of worse vision
b. Position to benefit vision
c. Remind others to use techniques that benefit vision
d. Use adequate lighting for activities that are being carried out
e. Wear glasses correctly
f. Take care of the glasses properly
g. Using a weak visual aid


NIC
Communication Improvement: Vision Deficits

1. Receiving a patient's reaction to damaged vision
2. Record the patient's reaction to vision damage (eg, depression, withdrawal, and reject reality)
3. Rely on the patient's remaining vision properly
4. Describe the environment to the patient
5. Do not move objects in a patient's room without notifying the patient
6. Identification of foods that are in the tub in relation to the numbers on the clock

Environmental Management

1. Create a safe environment for patients
2. Eliminate environmental hazards (for example, removable rugs and small, movable furniture)
3. Eliminate the terrible objects from the environment
4. Protect with rails / layers between rails, as they should
5. Take care of patients during activities on the ward as they should
6. Provide suitable high-low beds
7. Provide adaptive tools (eg benches for stepping or handrails) that are appropriate
8. Arrange the furniture in the room in an appropriate manner that is good in accommodating the inability of patients or families
9. Place objects that are often used close to the range
10. Lighting manipulation for therapeutic goodness
11. Limit visitors

Supervision: Security

1. Monitor changes in a patient's physical or cognitive function that cause harmful behavior
2. Monitor the potential for security hazardous environments
3. Determine the degree of supervision needed by the patient, based on the level, function and presence of danger in the environment
4. Provide the appropriate level of supervision to monitor patients and provide therapeutic measures, if needed
5. Place the patient in the most limited environment that provides the level needed for observation
6. Start and maintain a preventive status at high risk of danger specifically for care settings

Nursing Care Plan for Glaucoma : Assessment and Gordons 11 Functional Health Patterns

Tag : Acute pain, Disturbed Sensory Perception, Glaucoma, Nursing Care Plan, Nursing Diagnosis