Today clinical class included a presentation on cataracts. Cataracts is an important topic to discuss with the elderly especially because it appears to be an age related change most will experience although it can be caused by a number of other reasons. A cataract is a clouding of the lens inside the eye which leads to a decrease in vision. It is the most common cause of blindness and is usually treated with surgery. Vision loss occurs because opacity of the lens impedes light from passing and focusing on to the retina . The disease is usually detected by a visual acuity test where the Opthamologist place a Snellen chart and asks the patient to read the most visible line. In addition to the general knowledge, the main point that the presenter(Karla) place emphasis on was yearly eye examination especially in light of other co-morbidities such as diabetes. Recognizing that those with cataract commonly experience difficulty appreciating colors and changes in contrast, driving, reading, recognizing faces, and experience problems coping with glare from bright light were some of the other major points . Overall I thought this was useful presentation in that the residents were enthused and eager to learn as most of them had already had their lenses replaced. Furthermore, most of the residents verbalized that they would visit their eye doctor yearly and more frequently if they experience any vision loss.
Archive for April, 2013
Today’s clinical discussion about pain and pain management was very informative and pertinent to practicing nurses. The research presented suggests that most facility (LTC and Acute Settings) does not perform a noteworthy job of pain management. The primary reason for the mismanagement of pain is a direct result of the lack of understanding regarding the 2 basic types of pain, nociceptive and neuropathic and the accompanying treatment. Furthermore, nurses, iu thses settings, administer pain medications without following up to determine efficacy. Examples of nociceptive pain includes sprains, bone fractures, burns, bumps, bruises, inflammation (from an infection or arthritic disorder), obstructions, and myofascial pain (which may indicate abnormal muscle stresses). Nociceptors are the nerves which senses and respond to parts of the body suffering from damage. They signal tissue irritation, impending injury, or actual injury. When activated, they transmit pain signals (via the peripheral nerves as well as the spinal cord) to the brain. The pain is typically well localized, constant, and often with an aching or throbbing quality. Visceral pain is a subtype of nociceptive pain that involves the internal organs. It tends to be episodic and poorly localized. Conversely, neuropathic pain includes examples such as: post herpetic (or post-shingles) neuralgia, reflex sympathetic dystrophy / causalgia (nerve trauma), components of cancer pain, phantom limb pain, entrapment neuropathy (e.g., carpal tunnel syndrome), and peripheral neuropathy (widespread nerve damage). Among the many causes of peripheral neuropathy, diabetes is the most common, but the condition can also be caused by chronic alcohol use, exposure to other toxins (including many chemotherapies), vitamin deficiencies, and a large variety of other medical conditions. Neuropathic pain is usually the result of an injury or malfunction in the peripheral or central nervous system. The pain is often triggered by an injury, but this injury may or may not involve actual damage to the nervous system. Nerves can be infiltrated or compressed by tumors, strangulated by scar tissue, or inflamed by infection. The pain frequently has burning, lancinating, or electric shock qualities. Persistent allodynia, pain resulting from a non-painful stimulus such as a light touch, is also a common characteristic of neuropathic pain. The pain may persist for months or years beyond the apparent healing of any damaged tissues. When this happens, pain signals no longer represent an alarm about ongoing or impending injury, instead the alarm system itself is malfunctioning. The research shows if pain management is to be successful then nurses must also play their part in documenting using pain scales after pain administration.
