Like eyeglasses, contact lenses help to correct refractive errors and perform this function by adding or subtracting focusing power to the eye's cornea and lens. It is a tough, five-layered membrane that focuses light. The clear, dome-shaped surface that covers the front of the eye. Corneal abrasion : Scratch on the surface of the eye. It may present acute pain, photophobia, lacrimation , bleph-arospasm, foreign-body sensation, blurry vision and a history of contact lens wear or being struck in the eye.
Cortical cataract : It forms in the lens cortex, gradually extends its spokes from the outside of the lens to the center. Many diabetics develop cortical cataracts. It is located directly behind the iris and pupil, which focuses light onto the retina. It has the ability to vary its power to accommodate and focus light from objects at all distances.
Current prescription check: An evaluation of the current eyeglass prescription. Cyclophotocoagulation: A procedure that uses a laser beam to freeze selected areas of the ciliary's body - the part of the eye that produces aqueous humor - to reduce the production of fluid. Dacryoma: A tear-filled cyst caused by obstruction of a duct of the lachrymal gland. Depth perception: The ability of the visual system to perceive the relative positions of objects in the visual field.
The ability to distinguish objects in a visual field. Deuteranopia: A form of partial colour blindness of the dichromatic type in which the green colour of the spectrum is not perceived. Diabetic Retinopathy: Diabetes causes retinal degradation that can be sight-threatening. Dilated Fundus Examination: Dilation of the pupils with drops to allow a more thorough health evaluation of the back of the eye. A dilated retinal examination using the slit lamp biomicroscope and special lenses allows checking for retinal and optic nerve disease or abnormalities and evidence of systemic diseases such as diabetes and high blood pressure.
Diplopia: A condition in which a single object is perceived as two; it is also called double vision. Dry Eye : Occurs when there is not enough moisture in the eye, causing it to feel dry, hot, sandy, and gritty. It may be caused by low humidity, smoke, aging, certain diseases, and certain medications i.
Ectropion: Lid falling away from the eye, exposing the palpebral conjunctiva. Episcleritis: It is presented as relatively asymptomatic acute onset redness in one or both eyes. It is observed a sectoral injection of the episcleral and overlying conjunctival vessels, although the redness may be diffuse throughout these tissues. Eye coordination: T he ability of both eyes to work together as a team. Each of the eyes sees a slightly different image and the brain, by a process called fusion, blends these two images into one three-dimensional picture.
Good eye coordination keeps the eyes in proper alignment. Eye coordination is a skill that must be developed. Poor eye coordination results from a lack of adequate vision development or improperly developed eye muscle control. Although rare, an injury or disease can cause poor eye coordination. Eyeglasses: also called spectacles T he most common form of eyewear used to correct or improve many types of vision problems, are a frame that holds two pieces of glass or plastic, which have been ground into lenses to correct refractive errors.
Exophoria: A tendency of one or both eyes to divergent strabismus. Floaters : They appear as spots, dots, or lines and affect or interrupt vision. They are usually caused by bits of debris in the vitreous humor. Floppy eyelid syndrome: It is a relatively uncommon ocular condition characterized by flaccid, easily everted upper lids. It is usually seen in overweight, middle-aged males, although it may occasionally be seen in women and non-obese individuals.
Some patients also suffer from obstructive sleep apnea, a disorder marked by partial collapse of the pharynx during inspiration, resulting in loud snoring and gasping for air. Focusing ability: T est to measure eyes' ability to change focus. Giant papillary conjunctivitis: A common condition frequently seen in soft contact lens patients, patients with exposed suture knots, and patients with prostheses.
Patients with asthma, hay fever or animal allergies may be at greater risk. Glaucoma: A symptomatic condition of the eye in which the intraocular pressure exceeds the tolerance of the affected eye resulting in optic nerve damage and irreversible visual field defects. An Increased intraocular pressure that can result in optic nerve damage and loss of sight.
Gomoscopy: Exam technique of the angle of the anterior chamber using a corneal contact lens. Hyaloid canal: A narrow passageway that allows blood to flow through the eye. Hyperopia or Farsightedness: An error of refraction wherein parallel rays of light come to a focus behind the retina. A hyperopic person will have no problem seeing objects in the distance, but there will be difficulty in focusing clearly on near objects. Immune stromal keratitis: It is presented with pain, photophobia, lacrimation, and blepharospasm.
Vision is typically reduced in the acute, active phase. It may be either unilateral or bilateral. There will often be a history of ocular infection or systemic disease. It may be the initial manifestation of an unknown underlying systemic disease. Occasionally, it is idiopathic. It runs a chronic, indolent course and may persist for many months. Intraocular Pressure: The fluid pressure within the eye created by the continual production and drainage of aqueous fluid in the anterior chamber is known as the Intraocular Pressure.
Iridotomy: In this procedure, the surgeon uses the laser to make a small hole in the iris - the colored part of the eye - to allow fluid to flow more freely in the eye. Iris: The pigmented structure that gives our eyes their colour. The iris is partly responsible for regulating the amount of light permitted to enter the eye. Jaeger Test: Test to measure the near vision using lines of different sizes. Keratoconus: Special contact lenses that can help people with thinning, bulging corneas to see better. Klieg eye: Conjunctivitis caused by exposure to arc lamps Klieg lights.
Also called cinema eye. Lagophthalmia: A condition in which the eye does not close during sleep. Also called Hare eye. Laser surgery: O ften used to treat macular edema and proliferative retinopathy; involves shrinking the abnormal blood vessels, or sealing the leaking ones. Lens: Also called crystalline lens the transparent structure inside the eye that focuses light rays onto the retina. Limbal dermoids: Also known as epibulbar or conjunctival dermoids are generally seen as well-circumscribed oval mass lesions of the ocular surface.
They arise from the bulbar conjunctiva and virtually always protrude across the limbus onto the cornea. A Myopic person can see clearly objects upclose, but everything in the distance is blurred. Macula: The portion of the eye that allows us to see fine details clearly. Macular degeneration: Degeneration in the macular region of the retina that results in decreased central vision and sometimes, in blindness. Macular dystrophy: A group of disorders involving predominantly the posterior portion of the ocular fundus, due to degeneration in the sensory layer of the retina, retinal pigment epithelium.
Bruch membrane, choroids, or a combination of these tissues. Near point of accommodation: The closest point in front of the eyes that an object may be clearly focused. Near point of convergence: The maximum extent the two eyes can be turned inward. Nuclear cataract: It is most commonly seen as it forms. This cataract forms in the nucleus, the center of the lens, and is due to natural aging changes.
The normal pressure is about 10 to 20mmHg, with the majority of people falling between 13 and It is a part of the visual pathway. The optic nerve carries the impulses formed by the retina to the brain, which interprets them as images. Ophthalmologist: A medical doctor or an osteopathic physician who specializes in comprehensive eye care and provides examinations, diagnosis, and treatment for a variety of eye disorders.
Ophthalmologists are skilled in all facets of eye care, from prescribing eyeglasses or contact lenses to performing intricate eye surgery. Many also choose to specialize in one particular disease or portion of the eye i. Ophthalmoscope: Lighted instrument used to closely inspect eye structures and the inner back region of the eye.
Ocular hypertension : High greater than 21 mm Hg intraocular pressure. Optic nerve: Bundle of more than one million nerve fibres that connects the retina with the brain.
The optic nerve is responsible for interpreting the impulses it receives into images. Optician: A technician who fits, adjusts, and fills the prescriptions for eyeglasses and contact lenses. Optometrist: A doctor of optometry but not a medical doctor. Optometrists can examine, diagnose and manage many visual problems and eye disease, and are specially trained to test vision in order to prescribe eyeglasses or contact lenses.
The use of contact lenses to change the shape of the cornea in order to correct refractive error. Parakinesis: Irregularity of action of one f the ocular muscles. Phlyctenular keratoconjunctivitis: A nodular inflammation of the perilimbal tissues that occurs secondary to an allergic hypersensitivity response of the cornea. The disease has a worldwide distribution and is most often seen in women living in crowded or impoverished quarters.
Phoropter: It enables your eye doctor easily to switch lenses around to see which ones work best to correct your eyesight while you watch an eye chart positioned about 20 feet away. Photorefractive keratectomy PRK : Surgical procedure using an excimer laser to change the shape of the cornea. Pigmentary glaucoma: It often exhibits no symptoms at all.
Some pain and blurry vision may be noticed after exercise. It affects mostly white males in their mids to mids. Pinguecula : irritation caused by the degeneration of the conjunctiva. It is characterized by yellowish, slightly raised, interpalpebral lipid-like deposits in the nasal and temporal limbal conjunctiva. They are found frequently in individuals who are middle-aged and who experience chronic exposure to the sun. There is no predilection for sex or race. Posterior optical segment : Portion of the eye located behind the crystalline lens, and including vitreous, choroids retina, and optic nerve.
Posterior vitreous detachment PVD : The separation of the vitreous from the retina. It is also known as the aging eye is the condition when one starts to experience difficulty in reading and focusing on things close up, it is usually noticed first around the age of 45 and is a progressive condition. Primary glaucoma: Both open-angle and angle-closure glaucoma can be classified as primary or secondary. Primary glaucoma cannot be contributed to any known cause or risk factor.
Pterigion: Outgrowth. A raised, whitish, triangular wedge of fibrovascular tissue, whose base lies within the interpalpebral conjunctiva and whose apex encroaches the cornea. The leading edge of this tissue often displays a fine, reddish-brown iron deposition line Stocker's line. Pupil: The dark center in the middle of the iris through which light passes to the back of the eye. Pupil dilation: The pupil is widened with eye drops to allow a close-up examination of the eye's retina. Pupillary response: The constriction or dilation of the pupil as stimulated by light.
Radial keratotomy: A surgical procedure in which incisions are made into the epithelium of the cornea to correct refractive error. It is a test for eyes' ability to focus light rays exactly on the retina at distance and close-up. Refractive error: The degree to which light reaches the back of the eye. The degree, to which images received by the eyes are not focused on the retina, e.
The retina sense light and creates impulses that are sent through the optic nerve to the brain. The innermost layer of the eyeball. It is the tissue that transforms light into electrical impulses that are transmitted to the brain to create our sense of vision. Separation of the retina from the epithelium layer and from blood supply. Retinitis Pimentosa: The name given to a group of hereditary eye disorders. These disorders affect the retina, which is the light-sensitive tissue lining the back of the eye, in which the first stages of seeing take place. In RP, sight loss is gradual and progressive.
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It is unusual for people with RP to become totally blind as most retain some useful vision well into old age. Secondary glaucoma: Both open-angle and angle-closure glaucoma can be classified as primary or secondary. Secondary glaucoma develops as a complication of another medical condition or injury. In rare cases, secondary glaucoma is a complication following another type of eye surgery. Sensitivity to form: Visual sharpness far and near view field. Sclera: The white visible portion of the eyeball.
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The muscles that move the eyeball are attached to the sclera. Scleritis: It is presented with severe, boring ocular pain which may also involve the adjacent head and facial regions. The scleral vessels are significantly dilated, as are the overlying vessels of the episclera and bulbar conjunctiva. The affected eye may be so injected in some cases that the eye takes on a deep red, almost purple, hue.
Scotoma: An area of partial or complete loss of vision surrounded by an area of normal vision. Slit lamp: A microscope with attached lighting for the examination of outer and inner eye structures.
Snellen eye chart: Chart used to measure visual acuity. A series of letters are arranged in lines.
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The bottom of the chart typically begins with a line of very small letters that grow in size with each line until, finally, the standard "big E" can be seen at the top of the chart. Variations of the Snellen eye chart can include letter E's facing in different directions. Spots: often called floaters are small, semi-transparent or cloudy specks or particles within the vitreous, the clear, jelly-like fluid that fills the inside of the eyes. They appear as specks of various shapes and sizes, threadlike strands or cobwebs. Since they are within your eyes, they move as your eyes move and seem to dart away when you try to look at them directly.
Stereoscopic vision: The vision process involved in the use of a stereoscope, which presents an image from two slightly different angles so that the eyes can merge them into a single image in three dimensions. It is a lack of coordinated muscle movement or focusing ability between the eyes, causing the eyes to point in different directions. Also known as squint or crossed eye.
Subcapsular cataract: It begins at the back of the lens. People with diabetes, high farsightedness , retinitis pigmentosa or those taking high doses of steroids may develop a subcapsular cataract. Suspensory ligament of lens: a series of fibers that connect the ciliary body of the eye with the lens, holding it in place. Tonometry: A test to measure intraocular pressure for glaucoma.
Toxic conjunctivitis: It is a syndrome that results when the palpebral and bulbar conjunctiva have been chronically exposed to any number or combinations of foreign substances. The process may occur unilaterally or bilaterally, depending upon exposure. It includes the presentation of ocular itching, burning and tearing, injection of the bulbar and palpebral conjunctivae, chemosis, along with inferior and or superior eyelid follicle and papillae formation, and an absence of preauricular lymphadenopathy.
Trabeculoplasty: In this, most common type of laser surgery to treat open-angle glaucoma, a laser is used to place "spot welds" in the drainage area of the eye known as the trabecular meshwork which allows fluid to drain more freely. Trial frame and lens: A device which provides precise vision correction.
Trichiasis: Inversion of the eyelids in a way that the cornea is touched. Uvea: It includes the iris; the ciliary's body and the choroids. Uveitis: Inflammation of the uvea. It can be painful and may cause light sensitivity, floaters, and blurred vision. Vernal Keratoconjunctivitis: It is a chronic, bilateral inflammation of the superior and limbal palpebral conjunctiva.
The warmer the climate, the greater its prevalence.
Onset typically occurs between ages 3 and 25 years. Males typically are affected more than females. Viral conjunctivitis: It is caused by airborne respiratory droplets or direct transfer from one's fingers to the conjunctival surface of the eyelids.
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After an incubation period of five to 12 days, the disease enters the acute phase, causing watery discharge, conjunctival hyperemia and follicle formation. Lymphoid follicles are elevated, with avascular lesions ranging from 0. They have lymphoid germinal centers that have responded to an infectious agent. Vision: T he process by which light is perceived.
When the rod and cone cells of the retina are exposed to light, ranging in wavelengths from violet, about angstrom units, to nearly angstrom units, a chemical reaction takes place, causing discharge of a nervous impulse. This impulse reaches the brain, and creates in the conscious mind, the sensation of light. Visual acuity: The clearness of vision, which depends upon the sharpness of the retinal image. Also called eyesight. Visual acuity test: T he common eye chart test see right , which measures vision ability at various distances.
With respect to the defining characteristics and related factors, the average per person was 24 and 28, respectively. These diagnoses are the basis for planning nursing interventions and provide improved quality of life for these clients. Systemic arterial hypertension SAH and diabetes mellitus DM are chronic noncommunicable diseases CNCDs , that is, diseases that are persistent and require permanent care.
This alarming information is mainly due to sedentary lifestyle, obesity and the aging of the world population. Considering the increasing incidence of new cases of CNCDs, the need for preventive and control actions have become crucial, since they represent an important public health problem. For this, nursing needs to use tools, such as the Nursing Process NP , which, when executed using standard languages 7 and encompassing nursing diagnoses of NANDA International NANDA-I , 8 systematizes the care provided to the person, family or community focusing on the coprehensive care and interaction between professional-client-family.
In a systematic review of the evidence of the use of standardized nursing language, the authors emphasized the importance of conducting studies to link the use of taxonomies with the health outcomes of clients. Within this perspective, this study is of great relevance to improve the care of nurses working in PHC, as well as to corroborate or confront the existing NDs in the literature. Therefore, the objective of this study was to identify the profile of nursing diagnoses of hypertensive and diabetic people using Primary Health Care.
This is a postgraduate specialization with a weekly workload of 60 hours intended for in-service teaching of health-related professions, in this case, nurses. One of the structuring axes of residencies should be the comprehensiveness of care with the adoption of evidence-based practice; therefore, the use of the NP is essential.
Inclusion criteria were clients over 18 years of age with preserved cognitive ability, which was verified through the application of the Mini Mental State Exam, an important tool for screening cognitive impairment to be used in research and clinical evaluation, validated for the Brazilian population.
Data were collected at the participant's home or at their reference health unit by two researchers, from September to July The study population comprised adults with hypertension and diabetes. Data were obtained by primary source directly with the clients, through interview and physical examination. For the clinical evaluation of the participants and interview, a form prepared by the authors was used, based on two previous studies. The first, on the validation of a questionnaire with diabetic adults in Brazil and the other, on an instrument for nursing appointment of hypertensive patients in family health.
The collected data were examined based on the process of diagnostic reasoning proposed by Gordon, which involves the following steps: information collection, interpretation of information, grouping of information and denomination of nursing diagnoses, in this case, using the NANDA-I Taxonomy. The indications and inferences obtained, based on the scientific basis of nursing diagnoses, were performed by two authors independently.
One of the researchers was the one who collected and filled out the instruments with the clients, and the other researcher, a specialist in nursing diagnosis, member of NANDA-I, performed the diagnostic reasoning process based on the filled instruments. Afterwards, the nursing diagnoses were compared and, when there was disagreement, the two researchers debated until reaching an agreement. The data obtained were organized in a database built in the software Excel version and statistical analysis was done through the Statistical Package for the Social Sciences SPSS , version Data were collected after the participant signed the Informed Consent Form.
Of the hypertensive and diabetic subjects, The age ranged from 39 to 89 years, with a mean of The majority were married All interviewees lived in urban areas with access to running water and basic sanitation Table 1.
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Table 1 General characteristics of hypertensive and diabetic subjects. Minas Gerais Brazil, The average length of time patients lived with the disease was Regarding the risk classification of these users in the Hiperdia program, From the diagnostic reasoning process, 26 different diagnoses were identified, with a mean of 16 ND per client, 39 defining characteristics, 46 related factors and 62 risk factors Table 2.
Table 2 Distribution of nursing diagnoses, defining characteristics, related factors and risk factors formulated for the hypertensive and diabetic participants. Nursing diagnoses were observed in all clients: risk for ineffective gastrointestinal perfusion, risk for ineffective renal perfusion, risk for reduced cardiac tissue perfusion, risk for ineffective peripheral tissue perfusion, risk for impaired cardiovascular function.
Other high frequency diagnoses above the 75th percentile were: ineffective health control Nursing diagnoses were organized according to 75th, 50th, 25th and below 25th percentiles Table 3. In the data found, the nursing diagnoses that presented above the 50th percentile were analyzed. Table 3 3 Distribution of the nursing diagnoses formulated for the hypertensive and diabetic participants, according to the domains of human response and according to the percentile.
Table 4 below shows the distribution of the defining characteristics and the most significant related factors in the ND proposed for the hypertensive and diabetic clients of this study. It shows that, in relation to the ND with a high frequency, above the 75th percentile, that is, ''Ineffective Health Control'', the defining characteristics: Failure to include treatment regimen in daily living Table 4 Distribution of the 39 defining characteristics and 46 related factors of the nursing diagnoses proposed for hypertensive and diabetic clients. Table 4 Cont. Distribution of the 39 defining characteristics and 46 related factors of the nursing diagnoses proposed for hypertensive and diabetic clients.
Table 5 below shows the risk diagnoses of hypertensive and diabetic clients according to the vulnerabilities. The risk factor of high frequency, i. With regard to the ND "Risk for unstable blood glucose levels", the most commonly found risk factors were: Insufficient control of diabetes Regarding the ND "Risk for activity intolerance", the risk factor circulatory problem Table 5 Distribution of risk diagnoses and the 62 risk factors of hypertensive and diabetic clients. A person's life habits, beliefs and values characterize the way the individual identifies themselves within the social world.
Such attitudes are corroborated by socioeconomic and political factors that interfere with the environment, behavior and biology of these individuals, influencing the health-illness process and, consequently, their disposition, safety, independence and quality of life. The analysis of the data revealed that the majority of the interviewed population were female, married, had some religious practice, incomplete elementary education and average age of This reflects the reality of low- and middle-income populations around the world as they are most affected by chronic diseases and their complications.
The percentage of elderly people living with their children continues to be high, even with the increase in longevity, which corroborates the research carried out with elderly people assisted by the Family Health Strategy of a municipality in Minas Gerais, Brazil. This data shows that in the majority of clients interviewed, hypertension evolved with a prognosis for diabetes. From the epidemiological point of view, hypertension is considered three times more frequent in diabetics than in the general population.
However, despite the respective periods with the diseases, a considerable number of participants presented deficient knowledge about the meaning of the diseases, their complications, prognosis and treatment, mainly related to the use of insulin. The lack of information becomes an obstacle to user empowerment and to adherence to treatment. Hypertensive and diabetic patients are known have chronic conditions that require continuous nursing care in order to prevent complications from diseases. Health care priorities are defined in an equitable manner, according to the degree of risk they present, and high risk, observed in In view of the above, nurses should improve their practices, based on scientific evidence for decision making, which requires that nursing care is based on nursing diagnoses in order to prevent complications that affect quality of life of the hypertensive and diabetic individual in a general manner.
This study identified a total of 26 different nursing diagnoses, 13 problem-focused diagnoses, 12 risk diagnoses and one diagnosis of health promotion, presenting an average of 16 diagnoses per client, 24 defining characteristics, 28 related factors and 38 risk factors.