Which of the following procedures or assessments must the nurse perform when preparing a client for eye surgery?
A. Clipping the client’s eyelashes.
B. Verifying the affected eye has been patched 24 hours before surgery.
C. Verifying the client has been NPO since midnight, or at least 8 hours before surgery.
D. Obtaining informed consent with the client’s signature and placing the forms on the chart.
Correct Answer: C. Verifying the client has been NPO since midnight, or at least 8 hours before surgery.
Maintaining NPO status for at least 8 hours before surgical procedures prevents vomiting and aspiration. Historically, general anesthesia and retrobulbar blocks were used for intracapsular cataract surgery. However, with the advent of phacoemulsification and small incision surgeries, clinicians have since moved to local and topical anesthesia.
Option A: There is no need to clip the eyelashes unless specifically ordered by the physician. The ophthalmologic evaluation includes a thorough ophthalmic history, with a focus on visual acuity as well as comorbidities, and slit-lamp examination. Several measurements of the eye are then taken, including the anterior chamber depth, to determine intraocular lens refraction.
Option B: There is no need to patch an eye before most surgeries unless specifically ordered by the physician. While thorough medical history should be taken before surgery, routine systemic preoperative tests do not need to be ordered. Some institutions may require clearance from the primary care physician when patients have underlying systemic diseases.
Option D: The physician is responsible for obtaining informed consent; the nurse validates that the consent is obtained. With newer and well-developed techniques, cataract surgery is one of the most successful clinical managements in medicine with direct improvements in visual acuity as well as large improvements in activities of daily living and decreased mortality.
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