A nurse is giving instructions to a patient and their family regarding home care after cataract removal in the right eye. Which statement from the patient makes the teaching effective?

Appeared in: Uttarakhand CHO - 2021

Explanation

The core principle of post-cataract surgery care is to prevent increased intraocular pressure (IOP) and protect the eye from injury.
Since the surgery was on the right eye, the patient must avoid sleeping on the right side to prevent direct pressure on the surgical site.
This position helps prevent complications such as wound leakage, inflammation, or bleeding.
Acceptable sleeping positions are on the back or on the non-operated (left) side.

Option B: Sleeping on the left side is the correct and recommended position because it is the non-operated side and avoids pressure on the right eye.
Option C: Sleeping with the head elevated (e.g., using two pillows) is recommended to help reduce intraocular pressure and minimize swelling (edema) after surgery.
Option D: Patients are instructed to wear protective eyewear. This typically includes an eye shield, especially at night, and glasses or sunglasses during the day to protect the eye from injury and light sensitivity.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Post-operative care and patient teaching following cataract surgery in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Effective patient education is a critical nursing responsibility that directly impacts surgical outcomes. Clear, simple instructions prevent post-operative complications and reduce hospital readmissions.
Nurses must use the 'teach-back' method, where the patient verbalizes the instructions in their own words, to confirm understanding.
What if the patient also has severe sleep apnea and must sleep on their side? The nurse should collaborate with the surgeon to find a solution, such as using a special pillow to offload pressure or reinforcing the importance of sleeping only on the non-operated side.

How to Approach the Question

First, identify the key clinical details in the question: the procedure is cataract removal, the affected area is the right eye, and the goal is to verify correct patient understanding.
Recall the standard post-operative precautions for cataract surgery. The primary goals are to prevent pressure on the eye and avoid activities that increase intraocular pressure (IOP).
Evaluate each option against these standard precautions.
Option A: 'I will not sleep on my right side.' This aligns with the precaution to avoid pressure on the operated eye.
Option B: 'I will not sleep on my left side.' This is incorrect; the non-operated side is safe.
Option C: 'I will not sleep with my head elevated.' This is incorrect; head elevation is recommended.

Concept Tested & Keywords

Concept Tested: Post-operative care and patient teaching following cataract surgery.
Stem keywords: cataract removal, right eye, home care, teaching effective
Lead-in keywords: makes the teaching effective
Clinical cues: The surgery was on the right eye, which dictates the specific side to avoid during sleep.

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 1 p. 101-103

Practise the full Uttarakhand CHO - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.