A nurse is providing preoperative education to a client scheduled for cataract surgery. Which instruction should the nurse emphasize as the most important postoperative precaution?
1Apply warm compresses to the affected eye twice daily to reduce swelling
2Resume normal physical activities including heavy lifting within 24 hours
3Remove the eye shield immediately after surgery to assess visual improvement
4Avoid bending over, coughing forcefully, or straining during bowel movements✓ 정답
해설
Avoiding activities that increase intraocular pressure (e.g., bending over, coughing forcefully, straining) is critical after cataract surgery to prevent complications like bleeding or wound dehiscence. Other options describe less critical or incorrect postoperative care.
Clinical Judgment
This question assesses the ability to identify the priority preventive measure for patient safety after cataract surgery. The key is to recognize activities that increase intraocular pressure and to prevent potential surgical site complications (bleeding, wound dehiscence, intraocular lens displacement) that may result. Option 4 specifically lists actions that can sharply raise intraocular pressure (bending, forceful coughing, straining during constipation), making it the most important postoperative precaution.
Memory Tip:
Remember the mnemonic: Pressure Prevention is Priority. Or associate it with "Bend, Cough, Strain = Bad Complications."
KR vs US:
While the importance of intraocular pressure management is equally emphasized in Korea, U.S. NGN/CJMM questions often require selecting the single 'most important' action during patient education. Although other important instructions exist, such as 'wearing an eye patch' or 'administering eye drops,' the factor that poses an immediate and serious risk is 'increased intraocular pressure.'
Clinical Practice Guide
When educating patients, it is more effective to provide specific, actionable alternatives rather than saying "don't bend over," such as "lift your leg when putting on socks" or "squat down when picking up objects." To prevent constipation, recommend adequate fluid intake, fiber, and if necessary, taking a stool softener.
Caution:
If it appears as a SATA (Select All That Apply) question, answers like "wear an eye shield at night," "instill prescribed eye drops on time," and "do not rub the eyes" may also be correct. However, for questions asking for the single most important preventive measure, always choose preventing increased intraocular pressure.
Intraocular Pressure — Intraocular pressure. A rapid increase after cataract surgery can cause complications such as bleeding, wound dehiscence, and intraocular lens displacement.
Wound Dehiscence — A condition where the incision line at the surgical site opens up. It can occur due to increased intraocular pressure or external impact, and it increases the risk of infection.
Cataract — A condition where the lens of the eye becomes cloudy, leading to decreased vision. Surgery is performed by removing the cloudy lens and inserting an artificial lens.
Straining (during bowel movement) — Straining excessively during bowel movements. This causes a sudden increase in abdominal and intraocular pressure, placing stress on the surgical site.
Eye Shield — A plastic or metal shield worn to protect the eye after surgery. It prevents damage caused by unconsciously rubbing or pressing the eye, especially during sleep.