A nurse is caring for a male older adult client who has a new diagnosis of glaucoma. Which of the following should the nurse recognize as risk factors associated with this disease? Select all that apply

When a client reports constant itchiness in one eye, the nurse should ask focused questions to determine the cause and rule out conditions such as allergies, infection, or irritation. Key questions include asking about history of similar symptoms, duration, involvement of the other eye, and any associated drainage. These help identify whether the problem is acute, chronic, allergic, or infectious in nature.

Rationale for correct answers:
1. Has this happened before? Asking about recurrence helps identify if the issue is chronic, seasonal, or related to allergies.
2. How long have you had this problem? Duration helps determine whether the condition is acute or long-standing, guiding diagnosis.
3. Is the other eye ever itchy? Involvement of both eyes suggests allergic or systemic causes, while one eye may suggest localized irritation or infection.
4. Is there any drainage? Drainage can indicate infection or allergic response, making this a critical question.

Rationale for incorrect answer:
5. Do any family members have eye conditions? Family history is important for chronic diseases like glaucoma or macular degeneration, but it does not provide direct information about acute eye itchiness.

Take home points

• Key assessment questions → onset, duration, recurrence, involvement of both eyes, presence of drainage.
• Family history is useful for chronic eye conditions, not acute itching.

After a trabeculectomy, the client must avoid activities that increase intraocular pressure, such as bending, lifting, or straining, to allow proper healing of the surgical site. Engaging in strenuous housekeeping tasks may put pressure on the eye and compromise surgical success. Therefore, limiting housekeeping activities is a crucial part of postoperative teaching to promote recovery and prevent complications. Education focuses on lifestyle adjustments that protect the surgical site and vision during the healing phase.

Rationale for correct answer:
4. You need to limit your housekeeping activities: Housekeeping tasks often involve bending, lifting, and straining, which can increase intraocular pressure and compromise the healing of the surgical site. Teaching the patient to limit these activities promotes proper healing and reduces the risk of postoperative complications.

Rationale for incorrect answers:

1. You may resume playing golf: Golf requires significant bending and exertion, which may elevate intraocular pressure and endanger healing after trabeculectomy. It is not safe until cleared by the ophthalmologist.
2. You need to tilt your head back when washing your hair: Tilting the head back can cause water or shampoo to enter the eye, increasing the risk of infection or irritation. This practice is not recommended for patients after eye surgery.
3. You may continue driving to and from work: Driving may not be safe immediately after trabeculectomy due to potential blurred vision, discomfort, or risk of increased eye strain. It is unsafe until the patient is cleared by their eye specialist.

Take home points

• Patients must limit strenuous activities such as housekeeping after trabeculectomy.
• Golf, driving, and improper head positioning when washing hair are not safe until cleared by the provider.
• Protecting the eye from strain and pressure is essential for healing and preventing complications.