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Asuhan Keperawatan Glaukoma

Askep Glaukoma


Pengkajian

  1. Riwayat atau adanya faktor-faktor resiko :
    • Riwayat keluarga positif ( diyakini berhubungan dengan glaucoma sudut terbuka primer )
    • Tumor mata
    • Hemoragi intraokuler
    • Inflamasi intraokuler uveiti )
    • Kontusio mata dari trauma.

  2. Pemeriksanan fisik berdasrkan pengkajian umum pada mata dapat menunjukan :
    Untuk sudut terbuka primer
    Melaporkan kehilangan penglihatan perifer lambat ( melihat terowongan )
    Untuk sudut tertutup primer :
    • Kejadian tiba-tiba dari nyeri berat pada mata sering disertai dengan sakit kepala , mual dan muntah.
    • Keluhan -keluhan sinar halo, penglihatan kabur, dan enurunan persepsi sinar.
    • Pupil terfiksasi secara sedang dengan sclera kemerahan karena radang dan kornea tampak berawan.

  3. Pemeriksaan Diagnostik
    • Tonometri digunakan untuk mengukur Tekanan intra Okular. Glaukoma dicurigai bila TIO lebih besar dari 22 mmHg.
    • Gonioskopi memungkinkan melihat secara langsung ruang anterior untuk membedakan antara glaucoma sudut tertutup dan glaucoma sudut terbuka.
    • Optalmoskopi memungkinkan pemeriksa melihat secara langsung discus optic dan struktur mata internal.

  4. Kaji pemahaman klien tentang kondisi dan respons emosional terhadap kondisi dan rencana tindakan.


Diagnosa Keperawatan

  1. Nyeri berhubungan dengan spasme , tekanan intra ookuler, glaucoma akut.

  2. Ditandai dengan klien mengungkapkan rasa nyeri pada mata, klien melindungi sisi yang nyeri, mengerutkan dahi dan merintih.
    Kriteria evaluasi : mendemonstrasikan berkurangnya ketidaknyamanan, menyatakan nyeri hilang / berkurang, ekspresi wajah rileks, tak ada merintih.

    Rencana Perawatan :

    1. Pantau TD, nadi, dan Respirasi tiap 4 jam .
      Pantau derajat nyeri mata tiap 30 menit selama fase akut.
      Pantau masukan dan haluaran tiap 8 jam saat menerima agen osmotic intravena.
      Pantau ketajaman penglihatan setiap waktu sebelum penetesan agen oftalmik yang diintruksikan . Tanyakan bila obyek bersih atau kabur.
    2. Berikan agen optalmik yang diinstruksikan untuk glaucoma. Informasikan ke dokter jika :
      • hipotensi
      • haluaran urinarius kurang dari 240 ml / jam
      • Tak hilangnya nyeri pada mata dalam 30 menit terapi obat
      • Penurunan terus-menerus ketajaman penglihatan.
    3. Siapkan klien untuk tindakan pembedahan
    4. Pertahankan tirah baring pada posisi semi fowler. Cegah peningkatan TIO :
      • Anjurkan klien untuk menghindari batuk, bersin, mengejan, atau menempatkan kepala dibawah panggul
    5. Berikan lingkungan tenang dan hindari cahaya.
    6. Berikan anlgesik yang diresepkan dan evaluasi keefektifannya.


Artikel Terkait :

Glaucoma Treatment: Eye Drops
and Other Medications


By Marilyn Haddrill; contributions and
review by Charles Slonim, MD


Most treatments for glaucoma are designed to lower and/or control intraocular pressure (IOP), which can damage the optic nerve that transmits visual information to the brain.

Glaucoma eye drops often are the first choice over glaucoma surgery and can be very effective at controlling IOP to prevent eye damage. If you are a good candidate for glaucoma eye drops, you may be prescribed more than one type to achieve the best IOP control. In fact, many types of glaucoma eye drops can enhance the effects of other types.

Depending on your general health and other medical conditions, however, you may be a poor candidate for glaucoma eye drops. This is because medications placed in the eye are absorbed into the conjunctival blood vessels on the eye's surface. A certain percentage of the active ingredient of the medication, though small, will enter the bloodstream and may adversely affect functions such as heart rate and breathing.

Likewise, some types of eye drops may worsen certain existing medical conditions such as asthma. Some glaucoma drugs also can interact with other common medications such as digitalis, prescribed for heart conditions. So make sure you discuss these issues with both your family physician and your eye doctor.

Source : http://www.allaboutvision.com/conditions/glaucoma-3-treatment.htm

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