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Visual Impairment in the Elderly课程教案、知识点、字幕

大家好

在日常生活中

我们经常会听见老年人抱怨说

报纸的字太小看不清

又或者是

眼前好像总有小虫子在飞

感觉器官接收到的外界信息

85%以上是依靠眼睛获得的

所以

老年期发生的视觉障碍

使老年人的应对调节困难

影响了日常生活维持

外界信息获取

相互交流等

何为视觉障碍呢

视觉障碍是指

由于先天或后天原因导致视觉器官

眼球视觉神经

大脑视觉中心的构造

或功能发生部分或全部障碍

经治疗仍对外界事物无法或甚难

作出视觉辨识

国内有学者报道

60岁以上的老年人中

80%患有一种或几种眼病

其中白内障的发病率为60%

这些眼病所引起的视力障碍人数

在急剧增多

因此

如何识别和照护

这些视觉障碍的老年人就显得尤为重要

我们可以从健康史

视觉障碍的状况

辅助检查

心理社会状况等方面进行护理评估

询问老年人近半年内有无自觉视力改变

或视力减弱

头痛或眼睛疲倦以及症状发作的程度

部位 时间与特点等

对于经常佩戴眼镜的老年人

应该询问其最近的眼睛检查

及验光后重新配镜的时间

了解老年人有无全身性疾病

如糖尿病 高血压病等

了解老年人家族中有无青光眼

黄斑变性病史

视觉障碍的状况

应包括视觉功能情况

和眼科疾病情况两个方面

其中

与老化有关的视功能的变化主要有老视

视敏度和对比视敏感度开始下降

表现在视物的精细感下降

暗适应能力下降和视野缩小

眼科疾病如白内障

青光眼 糖尿病性视网膜病变

老年性黄斑变性等

使老年人的视力明显减退甚至失明

还可以通过眼科等检查

判断老年人视力障碍的类型及程度

常见的眼科疾患引起的视力减退

影响老年人看电视 书报

继而影响他们的饮食起居

以及外出 社会交往等

这些都会严重妨碍到

老年人的日常生活能力

导致自信心降低

容易产生消极悲观情绪

所以还要评估老年人是否有孤独

抑郁 自信心降低和自我保护能力受损等问题

视觉障碍老年人治疗

和护理的总体目标是采取有效措施

减少视力减退对老年人日常生活的影响

积极治疗眼科常见疾病和相关的慢性疾病

能够采取有助于保持眼睛健康的生活方式

在疾病治疗及护理方面

对于开角型青光眼

应遵医嘱正确使用滴眼剂来降低眼压

避免增加眼压的活动等

白内障 闭角型青光眼

常采用手术治疗

做好手术前后护理

特别是手术后

要告诉患者睡前应佩戴硬质的眼罩

近期内避免从事弯腰搬重物类体力活动

注意保持大便通畅

注意维持血糖和血压值在合适的范围内

防止或者是延缓部分白内障

糖尿病性视网膜病变的发生

注意观察眼压的变化

因年龄相关白内障在膨胀期

可诱发急性闭角型青光眼

用高渗剂后半小时测眼压

眼压控制不满意者

可考虑行前房穿刺

视网膜病变可采用激光

手术治疗 双眼覆盖眼罩

卧床休息

提供安全护理和心理支持等

视觉障碍老年人的一般护理措施

有以下几个方面

调节室内光线

提高照明度可弥补

老年人视力下降所造成的部分困难

指导阅读时间及材料

避免用眼过度疲劳

尤其是精细的用眼活动

最好安排在上午进行

看书报 电视的时间不宜过长

老年人对光亮对比度要求较高

所以为老年人提供的阅读材料

要印刷清晰

字体较大

最好用淡黄色的纸张

避免反光

帮助老年人熟悉日常用品放置的位置

使用的物品应简单

特征性强

为老年人创造一个物品放置固定

有序的生活环境

此外

多饮水

饮食宜清淡 易消化

保证充足的睡眠和一定的运动量

都是日常生活护理方面需要注意的事项

我们还应该给予老年人相应的健康指导

如定期眼科检查

指导老年人每年进行一次眼科检查

对于有糖尿病 心血管疾病病史的

老年人应缩短检查时间

如果近期自觉视力减退

或眼球胀痛伴头痛

应该尽快检查

明确病因

老年人眼睛或眼部的调节力

衰退是随年龄的增长而逐渐发展的

因此要根据定期眼科检查的情况

更换适合的眼镜

配镜前先要验光

确定有无近视

远视和散光

然后按年龄和老视的程度增减屈光度

同时还应考虑平时所习惯的工作距离

适当增减镜片的度数

如进行近距离精细工作

应适当增加老花镜度数

反之老花镜度数则应适当降低

患者的外出活动尽量安排在白天进行

在光线强烈的户外活动时

宜佩戴抗紫外线的太阳镜

从暗处转到亮处时

要停留片刻

待适应后再行走

反之亦然

滴眼剂的正确使用和保存也很重要

用滴眼剂前清洁双手

用示指和拇指分开眼睑

眼睛向上看

将滴眼剂滴在下穹隆

闭眼

再用示指和拇指提起上眼睑

使滴眼剂均匀地分布在整个结膜腔内

滴药时注意滴管不可触及角膜

每种滴眼剂使用前

均要了解其性能

维持时间 适应症和禁忌症

检查有无混浊 沉淀

是否在有效期之内

滴药后须按住内眼角数分钟

防止滴眼剂进入泪小管

吸收后影响循环和呼吸

平时要多备一瓶滴眼剂以备遗失时使用

使用周期较长的滴眼剂

应放入冰箱冷藏室保存

切不可放入贴身口袋

通过治疗与护理后

希望视力减退对老年人日常生活的影响

能够减少

眼科常见疾病和相关的慢性疾病能够得到改善

老年人能够保持规律

健康的生活方式

有助于眼睛的保健

谢谢大家

Gerontological Nursing课程列表:

CHAPTER 1: General Introduction to Geronological Nursing

-1.1 Human Life Expectancy and Age Classification of the Elderly

--Human Life Expectancy and Age Classification of the Elderly

--【Vedio Recommendation】 How do we measure life expectancy ?

-1.2 Population Aging

--Population Aging

--【Literature Recommendation】World Report on Ageing and Health: 2015

-1.3 Influence and Countermeasures of Population Aging

--Influence and Countermeasures of Population Aging

--【Literature Recommendation】World Population Ageing Highlights:2019

-1.4 Goals and Principles of Elderly Care

--Goals and Principles of Elderly Care

--【Book Recommendation】Evidence-Based Geriatric Nursing Protocols for Best Practice

-1.5 Theories Related to Elderly Care

--1.5.1 Personality Development Theory and Life Review

--1.5.2 Disengagement Theory and Activity Theory

--1.5.3 Self-efficacy and Chronic Disease Management

--【Vedio Recommendation】8 Stages of Development by Erik Erikson

--【Literature Recommendation】Activity Theory, Disengagement Theory, and Successful Aging

--【Book Recommendation】Self-Efficacy in Changing Societies

--【Literature Recommendation】Obstacles and Policies of the Social Capital Participates in the Combination of Medical Care and Pension: A Literature Review

-1.6 Elderly Support and Elderly Care

--1.6.1 Concepts of Elderly Healthcare, Elderly Support and Elderly Care

--1.6.2 Home-based Elderly Care Model

--1.6.3 Institutional Elderly Care Model

--1.6.4 Integrated Medical and Nursing Care Model

--【Vedio Recommendation】Day in the Life of Home Care

--【Website Recommendation】Official Website of the National Institutes of Health

-Concept Map

--【Concept Map】General Introduction to Geronological Nursing

-【Test】CHAPTER 1

-【Case Discussion】CHAPTER 1

CHAPTER 2: Elderly Health Assessment

-2.1 Aging Changes in the Elderly

--2.1.1 Aging of the Respiratory System

--2.1.2 Aging of the Cardiovascular System

--2.1.3 Aging of the Digestive System

--2.1.4 Aging of the Urinary System

--2.1.5 Aging of the Endocrine System

--2.1.6 Aging of the Motor System

--2.1.7 Aging of the Nervous System

--2.1.8 Aging of the Sensory System

--【Literature Recommendation】Exercise Attenuates the Major Hallmarks of Aging

--【Book Recommendation】Hazzard's Geriatric Medicine and Gerontology

-2.2 Comprehensive Health Assessment of the Elderly

--Comprehensive Health Assessment of the Elderly

--【Literature Recommendation】Instruments to evaluate mental well-being in old age: a systematic review

-2.3 Principles of Elderly Health Assessment

--Principles of Elderly Health Assessment

-2.4 Assessment of the Functional Status of the Elderly

--Assessment of the Functional Status of the Elderly

--【Literature Recommendation】The Lawton Instrumental Activities of Daily Living (IADL) Scale

-2.5 Assessment of Cognitive Function in the Elderly

--Assessment of Cognitive Function in the Elderly

-2.6 Assessment and Adjustment of the Living Environment for the Elderly

--Assessment and Adjustment of the Living Environment for the Elderly

--【Literature Recommendation】Age-friendliness of living environments from the older person’s viewpoint: development of the Age-friendly Environment Assessment Tool

-Concept Map

--【Concept Map】Elderly Health Assessment(1)

--【Concept Map】Elderly Health Assessment(2)

-【Test】CHAPTER 2

-【Case Discussion】CHAPTER 2

CHAPTER3: Elderly Mental Health and Mental Health care

-3.1 Overview of the Psychological Characteristics of the Elderly

--Overview of the Psychological Characteristics of the Elderly

-3.2 Influencing Factors of Psychological Changes in the Elderly

--Influencing Factors of Psychological Changes in the Elderly

-3.3 Common Psychological Issues and Their Management in the Elderly

--3.3.1 Common Psychological Issues and Their Management in the Elderly (1)

--3.3.2 Common Psychological Issues and Their Management in the Elderly (2)

--【Book Recommendation】Development Through the Lifespan

-3.4 Depression in the Elderly

--3.4.1 Overview of Depression in the Elderly

--3.4.2 Clinical Symptoms of Depression in the Elderly

--3.4.3 Caring for Elderly Patients with Depression

--【Website Recommendation】

--【Documentary Recommendation】Depression:Out of the Shadows

--【Literature Recommendation】Management of depression in older adults:A review depression in older people

-3.5 Elderly Patients with Dementia

--3.5.1 Identification of Dementia Symptoms in the Elderly

--3.5.2 Intelligence Rehabilitation of Elderly Patients with Dementia

--3.5.3 Safety Care of Elderly Patients with Dementia

--【Website Recommendation】The Global Voice on Demaentia

-Concept Map

--【Concept Map】Elderly Mental Health and Mental Health Care

-【Test】CHAPTER 3

-【Case Discussion】CHAPTER 3

CHAPTER4: Elderly Daily Care

-4.1 Precautions for Daily Care of the Elderly

--Precautions for Daily Care of the Elderly

-4.2 General Care of Elderly Skin

--4.2.1 Characteristics and General Care of Elderly Skin

--4.2.2 Skin Itching and Its Management in the Elderly

--【Website Recommendation】American Academy of Dermatology

-4.3 Clothing Hygiene for the Elderly

--Clothing Hygiene for the Elderly

--【Literature Recommendation】The Design Methods of Functional Clothing for the Elderly

-4.4 Dietary Care for the Elderly

--4.4.1 Nutritional Needs of the Elderly and Influencing Factors of these Needs

--4.4.2 Dietary Care for the Elderly

--【Book Recommendation】Nutrition Care of the Older Adult: a Handbook for Dietetics

--【Website Recommendation】Nutrition for older persons

-4.5 Sleep Guidance for the Elderly

--4.5.1 Sleep Characteristics of the Elderly

--4.5.2 Sleep Guidance for the Elderly

--【Book Recommendation】An Occupational Therapist's Guide to Sleep and Sleep Problems

--【Website Recommendation】American Academy of Sleep Medicine

-4.6 Exercises Guidance for the Elderly

--4.6.1 Evaluation of Exercise Intensity in the Elderly

--4.6.2 Precautions Elderly Undertaking Exercises

--【Website Recommendation】American College of Sport Medicine

--【Book Recommendation】Handbook of Activities for the Elderly

-Concept Map

--【Concept Map】Elderly Daily Care

-【Test】CHAPTER 4

-【Case Discussion】CHAPTER 4

CHAPTER5:Medication Safety and Care for the Elderly

-5.1 Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly

--Characteristics of Drug Metabolism and Pharmacodynamics in the Elderly

--【Website Recommendation】How Drugs Work In the Elderly

-5.2 Common Adverse Drug Reactions and Their Causes in the Elderly

--Common Adverse Drug Reactions and Their Causes in the Elderly

-5.3 The Principles of the Use of Medications in the Elderly

--The Principles of the Use of Medications in the Elderly

--【Literature Recommendation】The American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

-5.4 Prevention of Adverse Drug Reactions in the Elderly

--Prevention of Adverse Drug Reactions in the Elderly

--【Literature Recommendation】Drug-related falls in older patients: implicated drugs, consequences, and possible prevention strategies

-5.5 Medication Compliance in the Elderly

--Medication Compliance in the Elderly

-Concept Map

--【Concept Map】Medication Safety and Care for the Elderly

-【Test】CHAPTER 5

-【Case Discussion】CHAPTER 5

CHAPTER6:Nursing Care for the Elderly with Common Health Problems and Diseases

-6.1 Falls in the Elderly

--6.1.1 Epidemiological Characteristics of Elderly Falls

--6.1.2 Risk Factors for Falls in the Elderly

--6.1.3 Prevention of Falls in the Elderly

--【Website Recommendation】CDC STEADI(Stopping Elderly Accidents, Deaths & Injuries Tool Kit)

-6.2 Dysphagia in the Elderly

--Dysphagia in the Elderly

-6.3 Urinary Incontinence in the Elderly

--Urinary Incontinence in the Elderly

-6.4 Constipation in the Elderly

--Constipation in the Elderly

--【Literature Recommendation】Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management

-6.5 Dry Mouth in the Elderly

--Dry Mouth in the Elderly

--【Website Recommendation】Academy of Nutrition and Dietetics

-6.6 Elderly Nutritional Deficiencies

--Elderly Nutritional Deficiencies - emaciation

-6.7 Visual Impairment in the Elderly

--Visual Impairment in the Elderly

--【Website Recommendation】Senior Eye Exams

-6.8 Senile Deafness

--Senile Deafness

-6.9 Elderly Delirium

--Elderly Delirium

-6.10 Elderly Frailty

--Elderly Frailty

--【Literature Recommendation】Frailty in elderly people/Frailty in older people

-6.11 Pneumonia in the Elderly

--Pneumonia in the Elderly

-6.12 Hypertension in the Elderly

--Hypertension in the Elderly

--【Literature Recommendation】2018 Chinese Guidelines for Prevention and Treatment of Hypertension

-6.13 Stroke in the Elderly

--Stroke in the Elderly

-6.14 Stable Angina in the Elderly

--Stable Angina in the Elderly

--【Literature Recommendation】2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes

-Concept Map

--【Concept Map】Nursing Care for the Elderly with Common Health Problems and Diseases

-【Test】CHAPTER 6

-【Case Discussion】CHAPTER 6

CHAPTER7 Hospice Care for the Elderly

-7.1 Concept of Hospice Care

--Concept of Hospice Care

--【Website Recommendation】 Definition of Palliative Care,WHO

-7.2 Death Education

--7.2.1 Death Education (1)

--7.2.2 Death Education (2)

--【Book Recommendation】The Meaning of Death by Herman Feife

-7.3 Nursing for Pain in the Dying Elderly

--Nursing for Pain in the Dying Elderly

--【Journal Recommendation】

-7.4 Nursing for Major Bleeding in the Dying Elderly

--Nursing for Major Bleeding in the Dying Elderly

-7.5 Nursing for Delirium in the Dying Elderly

--Nursing for Delirium in the Dying Elderly

-7.6 Nursing for Dyspnea in the Dying Elderly

--Nursing for Dyspnea in the Dying Elderly

--【Website Recommendation】The Hospice and Palliative Nurses Association,HPNA

-7.7 Psychological Problems and Nursing in the Dying Elderly

--Psychological Problems and Nursing in the Dying Elderly

--【Book Recommendation】On Death and Dying ,by Elisabeth Kübler-Ross

-7.8 Grief Counseling for the Widowed Elderly

--Grief Counseling for the Widowed Elderly

--【Book Recommendation】I Wasn't Ready to Say Goodbye,by Noel·Brook,Blair·Pamela

-Concept Map

--【Concept Map】Hospice Care for the Elderly

-【Test】CHAPTER 7

-【Case Discussion】CHAPTER 7

FINAL EXAM

-Final Exam

Visual Impairment in the Elderly笔记与讨论

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