Assignment : Case Study

Case Study Case A 79-year-old male remarks on his first visit that he has noticed a gradual decrease in vision in both his eyes since last year. His old medical record has not yet arrived at your office. He states that since he moved from Florida a year ago, he has not had an eye examination and does not yet know an ophthalmologist. He is having difficulty carrying on his activities of daily living that involve his sight. He states that he cannot recognize people at some distance until they come quite close, and he is often frightened by his perception of strangers speaking to him. Watching television and reading are becoming increasingly difficult for him. He states that glare is a problem and notes that a few times he almost tripped over something on the floor. He still drives his car in the local community. He asks if you think he may have a cataract. He says his wife had two cataracts in the past and he remembers her complaining of vision problems, which have now been resolved. Vital Signs: BP 128/84; HR 82; RR 18; BMI 24. Assignment : Case Study

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Chief Complaint: Decrease in my vision; glare is very bothersome!

Questions

What additional subjective data are you seeking, including relevant family and social history?

What additional objective data will you be assessing?

What national guidelines are appropriate to consider? Kennedy-Malone Advanced Practice Nursing in the Care of Older Adults, 2e

What diagnostic tests will you order?

What are the differential diagnoses that you are considering?

What is your plan of care? Discuss additional resources as well that you will consider with this patient?

What additional patient teaching may be needed?

Will you be seeking consultation and if so, what will you request?

What additional considerations are you thinking about due to the age of this patient? Would your plan of care or patient teaching be different if this patient was younger? Assignment : Case Study