A 62 year old female is taking medication to treat her acute angle closure glaucoma disorder. Two months ago, the Dr. prescribed to Ms. Smith timolol maleate (Beta adrenergic blocking agent) to treat the symptoms of glaucoma. While she had taken the medication, her intraocular pressure (IOP) was controlled. One evening, the patient arrived to the eye care unit with a serious frontal headache, blurred vision, and eye pain. After the nurse assessed Ms. Smith visual field, she charted that the patient was not able to read 20 feet from the Snellen chart and her eyes were very sensitive to the light. The physician evaluation demonstrated that the patient had an elevated sign of intraocular ...view middle of the document...
At the same time, the nurse stresses that ending the medication can increase the risk of blindness and an overdose can also increase the side effects causing serious adverse effects such as, bradycardia and hypotension.
Generic Name: timolol maleate Brand Name: Timoptic
Drug Class: is a beta adrenergic blocking agent
Indication: indicated in the treatment of elevated intraocular pressure in patients with ocular hypertension, acute angle glaucoma and open-angle glaucoma. It reduces elevated intra ocular pressure (IOP).
Mechanism of Action: timolol is a beta- adrenergic blocking agent. Like other beta-adrenergic blocking agents, it mainly blocks the action of the sympathetic (adrenergic) nervous system. Timolol causes a reduction of the pressure within the eye. This effect is thought to be caused by a reduction in the production of the liquid (aqueous humor) in the eye. The reduction in intraocular pressure reduces the risk of damage to the optic nerve and loss of vision in patients with glaucoma.
Common Adverse Reactions: conjuntival irritation, eye pain, and lacrimation.
Serious or Life Threatening Adverse Reaction: Bradycardia, hypotension, hypertension, cerebral ischemia, cardiac failure, worsening of angina pectoris, palpitation, cardiac arrest, pulmonary edema, edema, claudication, confusion hallucinations, memory loss, anaphylaxis.
Nursing Considerations: administer eye drops properly to minimize systemic absorption; advised the patient not to breast feed while taking this drug without consulting physician; do not stop taking timolol unless instructed to do so by a health care provider. Assess pulse rate and BP at regularly and more often in patients with severe heart disease. (Cynthia, 2013)
The nursing process allows the nurse to identify and diagnose the health status of the patient and creates a route of action in order to address and solve the patient health’s problems. This ongoing process has well-organized sequences for the different steps that will lead the nurse to get the best nursing practices. These steps are: assessment, nursing diagnosis, planning, intervention, and evaluation. (Willihnganz Michelle, 2013)
The first phase of the nursing process is the assessment. It is where the nurse will collect all the data related with the patient’s health history. When Ms. Smith was admitted to the eye care unit of the hospital, the nurse performed the first phase of the nursing process. Ms. Smith’s nurse obtained:
• The vital sings including pulse, temperature and breathing were normal, BP was 140/85.
• Patient had family history associate with her acute angle glaucoma
• The nurse observed redness, drainage in her eyes, fixed pupils and cloudy cornea
• The patient didn’t have any type of eye injury
• The patient stated “ I have severe frontal headache, blurred vision, and eye pain”
• Patient was experiencing...