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Disturbed Body Image and Anxiety NCP for Endophthalmitis

Nursing Diagnosis and Interventions for Endophthalmitis

Endophthalmitis is a medical condition characterized by inflammation on the inside of the eyeball, typically caused by infection with bacteria, viruses or fungi. This condition usually occurs as a complication of surgery in the eye although it can also be caused by penetrating trauma to the eyeball. Regardless of the cause, the condition is dangerous and likely to lead to decreased vision or permanent loss of the eyeball itself. This condition typically arises accompanied by pain in the eye, decreased vision, and swelling of the eyelids. The prognosis of this condition varies depending on the cause, and how quickly acquire the handling and the presence of underlying disease; in general, the earlier the treatment is obtained and the smaller decrease in vision, the better the prognosis. Given the seriousness of the complications that can arise, it is recommended to a person with this condition to immediately consult with a doctor to get treatment.

Causes of endophthalmitis are:
  • Eye injury.
  • Bacterial infections.
  • Fungal infections.
  • Virus infection.
Signs and symptoms of endophthalmitis that may arise:
  • Fever.
  • Suffer from Headaches.
  • Eye pain.
  • Swelling of the eyes.
  • The blood vessels are swollen or dilated on the white part of the eye, which causes the eyes to appear red (red eye).
  • Blurred vision.
  • Reduced vision.
  • Sensitive to light.


Nursing Diagnosis for Endophthalmitis : Disturbed Body Image related to loss of vision.

Goal: body image disturbance does not occur.

Outcomes: Declare and indicate acceptance of the appearance of self-assessment.

Intervention:

1 Provide an understanding of the loss for the individual and those close, with respect to the invisibility of loss, loss of function, and the pent-up emotions.
Rationalization: With the loss of part or function of the body can cause the individual to the rejection, shocked, angry, and depressed.

2 Instruct individuals in response to the shortcomings are not the denial, shock, anger, and distress.
Rationalization: So that patients can receive shortcomings with more sincere.

3 Be aware of the influence of the reactions of other people on the shortcomings and push share that feeling with others.
Rationalization: When good family reactions can increase the confidence of individuals and can share that feeling with others.

4 Teach individuals to monitor their own progress.
Rationalization: Knowing how far the ability of individuals with its shortcomings.



Nursing Diagnosis for Endophthalmitis : Anxiety related to:
  • Physiological factors, changes in health status: the possibility / reality of vision loss.
  • Talk negatively about yourself.
  • Eyelashes falling fast.
Possibility evidenced by:
  • Fear.
  • Expressed concerns about the changes in life events.
Outcomes:
  • Looks relaxed and report anxiety levels decreased to be overcome.
  • Demonstrate problem solving skills.
Intervention:

1 Assess the level of anxiety. Help the patient identify coping skills that have been done successfully in the past.
R /: Integrating therapeutic intervention and participation in self-care, coping skills in the past to reduce anxiety.

2 Instruct to express feelings. Give feedback.
R /: Creating a therapeutic relationship. Helping people closest in identifying problems that cause stress

3 Give accurate and real information about what actions are performed.
R /: patient involvement in care planning gives a sense of control and help reduce anxiety

4 Provide quiet environment and rest.
R /: Move the patient from external stress, improve relaxation, help reduce anxiety.

5. Encourage the patient / person closest to claim attention, attention behavior.
R /: The act of support can help patients feel stress is reduced, allowing for directed energy on healing.

6 Provide information about disease process and anticipation of action.
R /: Knowing what to expect can reduce anxiety.

7 Collaboration of sedative drugs.
R /: Can be used to reduce anxiety and facilitate rest.


Nursing Care Plan for Endophthalmitis
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Nursing Care Plan for Endophthalmitis

Endophthalmitis - Nursing Assessment and Diagnosis

Definition of endophthalmitis

Endophthalmitis is inflammation of the lining around the inner eye, the fluid in the eyeball (the vitreous humor) and the whites of the eyes (sclera).

Endophthalmitis is a purulent inflammation (suppurative) within the eyeball. Is a purulent inflammation of the entire intra-ocular tissues is accompanied by the formation of abscesses in the body of the glass. Cause of Sepsis, orbital cellulitis, penetrating trauma, ulcer.


Classification

Endophthalmitis can be classified according to:
1 How to enter
  • Endogenous endophthalmitis caused by bacteria spread from elsewhere in the body through the bloodstream. The main fungi. Common predisposing factor is immunocompromised status, septicemia or IV drug abuse.
  • Exogenous endophthalmitis can occur as a result of penetrating trauma or infection in the open surgery eyeball. Endogenous endophthalmitis is very rare, only 2-15% of all endophthalmitis. The main bacteria.

2. Types of agents causing
  • bacteria
  • fungi
  • virus
  • parasites


Etiology

The cause of endophthalmitis among others:
  1. Surgery.
  2. Wounds that penetrate the eye.
  3. Bacteria. The cause of most is Staphylococcus epidermidis, Staphylococcus aureus, and Streptococcus species.
  4. Fungi. The cause of most is Aspergillus, phycomycosis and Actinomyces.


Signs and Symptoms

Inflammation caused by bacteria will provide clinical manifestations of severe pain, red and swollen eyelids, difficult petals opened, chemotic and red conjunctiva, cornea cloudy, cloudy anterior chamber. In addition, there will be a decrease in visual acuity and photophobia (fear of light). Endophthalmitis due to surgery is common after 24 hours and eyesight would worsen with the passage of time. When already deteriorating, will be formed hypopyon, the white fluid-filled sac, in front of the iris.

The symptoms are often severe, which are:
  1. eye pain
  2. redness of the sclera
  3. photophobia (sensitive to light)
  4. visual impairment.

Signs often appear:
  1. eyelids red,
  2. swelling, and difficult to open,
  3. cloudy cornea,
  4. murky chamber of the eye.


Pathophysiology

Endophthalmitis or corpus vitreous abscess is severe inflammation within the eye, usually caused by trauma or surgery, or endogenous due to sepsis. Shaped suppurative inflammation within the eye, and will lead to an abscess in the body of the glass. Exogenous endophthalmitis caused by penetrating trauma or secondary infection following surgery on the open eyeball. Endogenous endophthalmitis caused by the spread of bacteria, fungi or parasites from the focus of infection in the body.
Inflammation by bacteria provide a picture of severe pain, red and swollen eyelids, anterior chamber murky, sometimes accompanied by hypopyon. In the body of the glass can be found masses of white gray and light hippion satellite abscesses form in the body of the glass.



NURSING CONCEPTS

A. Assessment
  • Assessment sharp eyesight.
  • Assessment of pain.
  • Symmetry eyelid.
  • Eye reaction to light / eye movement.
  • Color eyes.
  • The ability to open and close the eyes.
  • Assessment of visual field.
  • Inspect the outside structure of the eye and inspection nodes for the presence of swelling / inflammation.

Data Focus
  • Pain (mild to severe).
  • Photophobia (sensitivity to light) or blepharospasme (eyelid spasms).
  • Sharpness of vision.


Nursing Diagnosis
  1.  Acute Pain: eye related to inflammation and inflammatory processes.
  2.  Disturbed Sensory Perception (specify: visual) related to the inflammatory process.
  3.  Disturbed Body Image related to loss of vision.
  4.  Disturbed Sleep Pattern related to pain.
  5.  Anxiety related to lack of knowledge about the disease.
  6. Knowledge Deficit related to lack of information.
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