A nurse is teaching a client who is experiencing a change in vision.
Which of the following statements indicates that the client might be developing cataracts?

Choice A rationale

An incessant cough increases intraocular pressure and puts excessive strain on the surgical site during and after a cataract extraction. Coughing can lead to wound dehiscence or an intraocular hemorrhage. The nurse must investigate this because it might necessitate postponing the procedure to ensure client safety and optimal surgical outcomes. Respiratory infections or chronic coughs are significant contraindications for elective eye surgeries that require a stable, quiet field.

Choice B rationale

Aspirin is a platelet aggregation inhibitor that increases the risk of bleeding during surgical procedures. Stopping aspirin one week prior to surgery is a standard preoperative instruction to allow platelet function to recover. This statement indicates that the client followed preoperative protocols correctly. Since the client complied with safety measures to reduce hemorrhagic risks, no further investigation is required by the nurse regarding this specific medication management before the eye surgery.

Choice C rationale

Managing blood pressure medications while fasting for surgery is a common concern for clients. While some providers want specific medications held, others prefer them taken with a small sip of water. The nurse should clarify the specific provider orders, but this statement typically reflects a client trying to adhere to NPO status. It is a common preoperative behavior that requires simple clarification rather than a deep investigation into an unexpected or dangerous physical symptom.

Choice D rationale

Removing contact lenses before eye surgery is a standard requirement to prevent infection and allow for proper surgical preparation of the eye surface. The client stating they did not put them in shows adherence to preoperative instructions. This is a positive safety action and does not indicate a complication or a need for the nurse to investigate further for potential surgical risks or underlying medical issues that could compromise the cataract procedure.

Choice A rationale

Cataracts involve the clouding of the crystalline lens of the eye, which normally focuses light onto the retina. As the lens becomes opaque due to protein clumping, light is scattered rather than focused, resulting in blurry or hazy vision. This progressive condition affects visual acuity and makes objects appear as if the person is looking through a frosted or fogged-up window, which is a classic clinical manifestation of cataract development.

Choice B rationale

The presence of dark spots moving across the visual field is usually indicative of vitreous floaters or potentially a retinal detachment. These spots are caused by shadows cast on the retina by microscopic fibers within the vitreous humor. While common with aging, they are not a primary symptom of cataracts, which focus on the clarity of the lens itself rather than the integrity of the vitreous or the posterior segment of the eye.

Choice C rationale

The inability to see objects from the side of the eyes refers to a loss of peripheral vision, which is a hallmark sign of glaucoma. In glaucoma, increased intraocular pressure damages the optic nerve, typically starting with the outer fibers that provide side vision. Cataracts generally cause a global decrease in clarity across the entire visual field rather than a specific loss of peripheral sight while maintaining central vision as seen in glaucoma.

Choice D rationale

Losing the ability to see things in the middle part of the eyes is characteristic of macular degeneration. The macula is responsible for sharp, central vision required for activities like reading or driving. Damage to this area causes a central blind spot or blurriness. Cataracts, conversely, create a generalized haze. While a cataract can be central, the specific complaint of losing central vision specifically points more toward retinal or macular pathology.