Page 1934 - Saunders Comprehensive Review For NCLEX-RN

b. Primary angle-closure glaucoma
(PACG) results from blocking the
outflow of aqueous humor into the
trabecular meshwork; causes include
lens or pupil dilation from medications
or sympathetic stimulation.

3. Assessment

a. Early signs include diminished
accommodation and increased IOP.
b. POAG: Painless, and vision changes are
slow; results in “tunnel” vision
c. PACG: Blurred vision, halos around
lights, and ocular erythema
4. Interventions for acute angle-closure glaucoma

Acute angle-closure glaucoma is a medical emergency that

causes sudden eye pain and possible nausea and vomiting.
a. Treat acute angle-closure glaucoma as a
medical emergency.
b. Administer medications as prescribed
to lower IOP.
c. Prepare the client for peripheral
iridectomy, which allows aqueous
humor to flow from the posterior to
the anterior chamber.
5. Interventions for the client with glaucoma

a. Instruct the client on the importance of
medications to constrict the pupils
(miotics), to decrease the production of
aqueous humor (carbonic anhydrase
inhibitors), and to decrease the
production of aqueous humor and IOP
(beta blockers).
b. Instruct the client about the need for
lifelong medication use, to wear a
MedicAlert bracelet, to avoid
anticholinergic medications to prevent
increased IOP, and to contact the
primary health care provider (PHCP)
before taking medications, including
over-the-counter medications.
c. Instruct the client to report eye pain,
halos around the eyes, and changes in
vision to the PHCP.

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