b. Observation. The patient should be observed for tendencies to cough or
sneeze (smoker's cough, allergies, and so forth). Such observations should be reported
to the professional nurse for consideration in the plan of care. Such violent movements
of the head during the postoperative course may cause increased intraocular pressure,
leading to hemorrhage or rupture of incisions.
c. Education. The patient must receive a thorough education about the
postoperative course of events and his responsibilities and restrictions. The patient
must understand the objective of resting the eyes and avoiding actions that increase
intraocular pressure.
(1)
The head must be kept very still.
(2)
No reading.
(3)
No showers, no shampooing, no tub baths.
(4)
No bending over at the waist.
(5)
No lifting of heavy objects.
(6) No sleeping on the operative side. If both eyes are affected, the patient
must sleep on his back.
d. Physical Preparation.
(1) A bowel prep is done the evening prior to surgery to prevent the patient
from straining at stool during the immediate post-op period.
(2) Shaving of eyebrows, cutting of eyelashes, and shaving of face should
be done only on the order of the surgeon.
(3) After the patient has been taken to surgery, prepare a post-op bed,
ensuring that the bed is equipped with side rails.
(4)
Sand bags should be made available for use in immobilizing the head.
e. Family. Often, if the patient must be kept absolutely still or will be temporarily
blinded after surgery, a member of the family may be asked to stay with the patient. If
this is the case, the family member should receive the same orientation and education
given to the patient.
MD0919
1-23
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