A nurse is preparing to care for a patient who has consented to corneal donation after death. Which action should the nurse take to maintain the viability of the corneal tissue?
1Keep the patient's eyes open to prevent corneal drying
2Close the patient's eyelids and place moist gauze over the eyes✓ 정답
3Apply antibiotic ointment directly to the corneal surface
4Position the patient in Trendelenburg position to improve circulation
해설
Proper eye care for corneal donation involves closing the eyelids and placing moist gauze over the eyes to maintain corneal hydration and prevent tissue damage. Other options can cause drying, contamination, or improper positioning.
Clinical Judgment
This question asks about the nurse's core actions for maintaining tissue viability for corneal donation after brain death. The key is maintaining moisture and aseptic conditions of the corneal tissue. If the cornea dries out or is damaged, transplantation becomes impossible, so the standard protocol is to close the eyelids and cover them with moist gauze to prevent drying and protect from external contamination.
Memory Tip:
Remember Close and Keep Moist. For corneal donation, the eyes must be closed (C) and moisture (KM) must be maintained.
KR vs US:
The nursing principles after corneal donation are the same in Korea and the United States. However, in Korea, according to the 'Organ Transplant Act,' the determination by the Brain Death Determination Committee and family consent are mandatory, and there is no difference in following detailed hospital protocols for tissue handling after donation. The nurse's role is to provide standardized care that maximizes tissue viability.
임상 시나리오
Clinical Practice Guide
Key roles of the nurse when preparing for corneal donation:
1. Gently close the eyelids and lightly cover the eyes with gauze moistened with sterile saline.
2. Notify HCP! Maintain the patient's body temperature within the normal range (36-37°C). Hypothermia can accelerate tissue damage.
3. Confirm the arrival time of the donor tissue procurement team (or ophthalmologist) and cooperate.
Caution:
If adapted into a SATA (Select All That Apply) question, options such as "open the eyes," "apply antibiotic ointment directly to the cornea," or "position the patient in a specific posture" are incorrect. Any action that directly touches the corneal surface or could compromise the sterile condition is strictly prohibited.
핵심 개념
Corneal Donation (각막 기증) — Process of collecting corneal tissue after death and transplanting it into patients with vision loss. The cornea is a tissue with a relatively low risk of rejection because it has no blood vessels.
Brain Death (뇌사) — A state where all functions of the entire brain, including the brainstem, have irreversibly ceased. Even if cardiopulmonary function is artificially maintained, it is legally and medically considered death, and this is the point at which organ donation becomes possible.
Tissue Viability (조직 생존력) — The ability of tissue to maintain function within a living body or to engraft after transplantation. In the case of the cornea, moisture retention and structural integrity are key factors for viability.
Aseptic Technique (무균 기술) — Procedures to prevent contamination by microorganisms. When handling donated tissue, strict aseptic techniques are required to prevent tissue infection and ensure recipient safety.
Moist Gauze (습윤 거즈) — Gauze moistened with sterile saline solution, etc., to maintain moisture without excess. It is used to protect the cornea from drying while preventing immersion or friction damage.