Mrs. Jones, a 65-year-old Caucasian female complained of night blindness that has been progressing over the past several months. She has a difficult time driving at night, and just attributed this to old age. She reports that her vision during the daytime is fine. She has no history of any visual problems in the past. She disclosed that she has been on a keto diet for almost a year, and dislikes vegetables and rarely eats fruits.
1. In your understanding of nutrition, what vitamin deficiency can this patient suffer from? Do you think her diet contributed to her symptoms?
2. What vitamin supplement do you expect the healthcare provider to prescribe?
Mrs. Jones consulted an ophthalmologist. To fully examine the retina and optic nerve, atropine ophthalmic (anticholinergic) to both eyes was ordered.
3. When Mrs. Jones asked what the eyedrops are for, and how will they help with the examination, how will you explain it to the patient?
4. Compare and contrast myopic and mydriatic drugs and uses of both.
5. What patient teaching is needed after the use of mydriatic drops?
A day after Mrs. Jones was seen at the ophthalmologist’s office, she came back with complaints of pruritus and burning sensation around the periorbital area. The skin around the eyes are swollen and red. The patient was told that the atropine drops may have caused an allergic reaction and has to be treated for contact dermatitis with a topical steroid.
6. What patient teaching should you include regarding the use of a topical steroid? Are there any special instructions for using topical steroid around the eye area? What are the adverse effects of this medication?
7. Using a concept map, provide a graphic representation of the relationships between all the symptoms presented, and the pharmacological agents that correspond to each. Include the diagnosis, the drug class, brand name, nursing considerations and adverse effects. A concept map template is provided for you. Edit it to fit the case scenario as you see fit.