Medical-Surgical Nursing:Assessment and Managementof Clinical Problems 9th Edition by Sharon Lewis,Shannon Ruff Dirksen,Margaret McLean Heitkemper,Linda Bucher

Exercise 34

CASE STUDY: Chronic Open-Angle Glaucoma Patient Profile A.G., a 58-year-old African American woman, was seen in her ophthalmologist's office for a routine eye examination. Her last examination was 5 years ago. Subjective Data
• Has no current ocular complaints
• Has not kept annually scheduled examinations because her eyes have not bothered her
• Takes metoprolol tartrate (Lopressor) for hypertension
• Has a family history of glaucoma
• Uses over-the-counter diphenhydramine (Benadryl) for her seasonal allergies Objective Data
• BP: 130/78
• HR: 72 bpm Ophthalmic Examination
• Visual acuity: OD 20/20, OS 20/20
• Intraocular pressure: OD 25, OS 28; by Tono-Pen tonometry
• Direct and indirect ophthalmoscopy: small, scattered retinal hemorrhages; optic discs appear normal with no cupping
• Visual field perimetry: early glaucomatous changes, OU Collaborative Care The health care provider prescribes betaxolol (Betoptic) gtt 1 OU. The nurse instructs A.G. on the reasons for the drug and how to do punctal occlusion.
-If topical therapy does not control A.G.'s intraocular pressures, what should she be told about alternative therapies?