Problem
J.K. is a 68-yr-old black woman with a history of osteoarthritis and type 2 diabetes for the past 15 years. She now has diabetic retinopathy. She returns to the eye clinic with her daughter for continued care of primary open-angle glaucoma (POAG) and reexamination for changes in diabetic retinopathy. Her current drug therapy for POAG includes topical timolol maleate 0.5% extended (Timoptic-XE) once daily in both eyes (OU) and latanoprost (Xalatan) 0.005% OU daily at bedtime. At her last examination, she had microaneurysms and hard exudates of the retina.
A. Explain the cause of the new scotoma.
B. Why is ALT an appropriate therapy for J.K.?
C. What is the purpose of the eyedrops before and immediately after ALT?
D. What is the cause of the vision loss from diabetic retinopathy?
E. Priority Decision: Based on the assessment data, what are the priority nursing diagnoses? Are there any collaborative problems?
F. Priority Decision: What are the priority nursing interventions for J.K.?
G. Patient-Centered Care: What are the priority topics that should be discussed in discharge teaching with J.K.?
H. Evidence-Based Practice: J.K. wants to know if her glaucoma is related to her diabetes. How would you respond to her question?