P.J. is a 74-year-old female who has been seen multiple times in the past with a complex medical history. Most recently, she was discharged one month ago after a 14-day stay for gangrenous open cholecystectomy. The gangrene extended into the common bile duct and she suffered a bile leak postoperatively. On this visit to the emergency room, she is complaining of diminished vision in the left eye for the past seven days. She is currently taking the following medications:
valsartan 160 mg/25 mg PO daily
amitriptyline 25 mg PO daily
aspirin 81 mg PO daily
alprazolam 0.25 mg every 6 hours PRN for anxiety
Subjective Data
States her vision has become “fuzzy and distorted†in the left eye
States, “I survived that horrid ordeal with my gallbladder and now I have trouble with my vision.â€
Never married; has a good support system with friends and caretakers
Objective Data
Physical Examination
Blood pressure 119/79, pulse 82, temperature 97.7° F, respirations 16
Alert and oriented to person, place, and time
Diminished breath sounds bilateral lower lobes posteriorly
Oxygen saturation 96% on room air
1. List and explain; six potential causes of P.J.’s blurry vision.
2. Analyze additional health history information and describe what would be included in P.J.’s focused nursing assessment.
3. Detail early signs and evaluate risk factors of age-related macular degeneration (AMD).
4. Determine what diagnostic tests determine if P.J. has age-related macular degeneration.
5. Discuss the necessary diet related teaching/changes that need to be provided to P.J.
