Following a severe corneal ulcer, the patient had keratoplasty (corneal transplant). What information should be included in the nursing plan of care?

Question

Select all that apply.
1. Wear an eye shield the first 24 hours and then at night until several weeks postoperatively as directed by healthcare provider.
2. Avoid lifting, sneezing, coughing, or bending over at the waist.
3. Report any change noted, such as increased pain, drainage, bleeding, floaters, and cloudiness.
4. Administer all eyedrops and ointments in a sterile manner.
5. Administer mydriatics during the postoperative period.

Answer 1

Correct Answer: 1, 2, 3, 4
An eye shield is needed to remind the patient not to touch or bump the eye until complete healing of the corneal transplant has occurred. At night, the eye is protected to avoid possible scratching or trauma while asleep. Lifting, sneezing, coughing, or bending will increase intraocular pressure and should be avoided while the corneal transplant is healing. Any change (pain, drainage, bleeding, floaters, or cloudiness) should be reported immediately, since a complication might have developed (e.g., rupture of suture, infection, internal tears). The use of sterile technique is needed for eye medication after surgery to prevent introduction of bacteria or trauma from touching the eye. Mydriatics will dilate the pupil of the eye and increase intraocular pressures. Therefore, they are not given postoperatively because they will minimize blood flow and healing. Mydriatics are used in the preoperative phase to visualize the internal structures.