Nursing care of Rhegmatogenous retinal detachment who received Pars plana vitrectomy, Scleral bucking Liquid silicone oil and Endolaser treatment

Abstract

The purpose of this case study was to examine the patient Rhegmatogenous Retinal Detachment patient who was treated in Eye-Ear-Nose-Throat ward, Chaiyaphum Hospital. Author study from 3-24 August 2020. The patient was 34 year-old Thai male came to see the doctor in order to follow up the appointment on 3 August 2020, 10.08 a.m. The significant symptom was right blurred eye. The patient was diagnosed as having Rhegmatogenous Retinal Detachment (RRD) and needed to be treated by Pars Plana Vitrectomy, Scleral bucking, Liquid silicone oil and Endolaser treatment in order to bring the retina back to normal condition. On 4 August 2020, the patient’s vital signs was temperature=36.5 C, pulse 80/mm, respiration rate 20/min, blood pressure 110/72 mm.Hg. Physical examination result: Visual Acuity Test (VA) right eye PJ (Projection of light) left eye 20/20. RRD was found from retina examination. Laboratory result: Hematocrit=46.3%, White Blood Cell=6.4 k/ul, Red Blood Cell=5.3 millum/ul, Platelet count=182,000 cell/mm3, Hemoglobin=15.0 g/dl, BUN=7.1 mg/dl, Creatinine=.078 mg/dl, Sodium=140 mEq/L, Potassium=3.9 mEq/L, Chloride=103 mEq/L, Bicarbonate=30.5 mEq/L, normal chest X-ray result. These following nursing problems were found: Preoperative period 1) patient’s anxiety from lacking knowledge of the disease, the treatment also preoperative and postoperative practice 2) risk for fall down accident from decrease in visual capability. Intraoperative period 1) risk for wrong patient operation, wrong eye and wrong position during operation 2) risk for surgical wound infection 3) risk for danger orsurgical instruments left over 4) risk for nearby organ injury. Postoperative period 1) risk for airway obstruction due to anesthesia 2) risk for hypothermia 3) uncomfortable condition causing by pain after surgery and risk for high Intra ocular pressure from the surgery and silicone oil injection 4) risk for repeated retinal detachment due to lack of postoperative practicall and home recovery knowledge. The nursing care was performed according to the schedule. The patient was alert and normally vital signs. He was discharged after 5 days. The doctor made the follow up appointment on 24 August 2020