A nurse is caring for a client whose partner recently died. The nurse sits with the client to provide comfort.

Which of the following ethical principles is the nurse demonstrating?

This statement indicates that the client understands the need to avoid activities that can increase intraocular pressure, such as lifting heavy objects, bending over, coughing, or straining. An increase in intraocular pressure can cause complications such as bleeding, inflammation, or recurrent detachment of the retina.

Choice B is wrong because sewing is a near-vision activity that can cause eye strain and fatigue. The client should avoid near-vision activities for at least two weeks after surgery.

Choice C is wrong because jogging is a vigorous exercise that can cause jarring movements and increase blood pressure. The client should avoid vigorous exercise for at least six weeks after surgery.

Choice D is wrong because bending at the waist can increase intraocular pressure and compromise the healing of the retina. The client should avoid bending at the waist for at least two weeks after surgery.

The retina is the light-sensitive layer of tissue that lines the back of the eye.

It converts light into electrical signals that are sent to the brain through the optic nerve.

A detached retina occurs when the retina separates from its underlying tissue due to a tear, hole, or break in the retina.

This can cause vision loss or blindness if not treated promptly.

The most common treatment for a detached retina is a surgery called vitrectomy. It typically involves three main steps:

• The vitreous gel inside the eye must be removed.
• A gas bubble is injected into the eye to hold the retina against its underlying tissue while allowing it to heal.
• Laser or cryotherapy creates scar tissue that helps reattach the retina.

The recovery time after retinal detachment surgery varies depending on the type and extent of the detachment, the type of surgery, and the individual healing process of the client.

Some general guidelines to follow after retinal detachment surgery are:

• Rest your eyes for at least two weeks after the surgery.
• Wear sunglasses when outdoors, as bright light may cause discomfort and strain on the eye that has been operated upon.
• If your doctor recommends, use artificial tears every few hours to keep moisture in the eye and lubricate it correctly.
• Take your medicines as directed by your doctor.
• You may use ice on your eye to reduce swelling

Warfarin is a vitamin K antagonist that inhibits the synthesis of factors II, VII, IX, and X in the liver. These factors are part of the extrinsic and common pathways of coagulation, which are measured by the prothrombin time (PT) and the international normalized ratio (INR). The INR is a standardized way of reporting the PT that accounts for the variability of different reagents and instruments. The INR is used to monitor the therapeutic effect of warfarin and to adjust the dose accordingly. The target INR range depends on the indication for warfarin, but it is usually between 2 and 3 for most conditions.

Choice B is wrong because fibrinogen level is not affected by warfarin.

Fibrinogen is a precursor of fibrin, which forms the final step of the coagulation cascade.

Fibrinogen level can be decreased in conditions such as disseminated intravascular coagulation (DIC), liver disease, or severe bleeding.

Choice C is wrong because aPTT is not affected by warfarin.

aPTT measures the intrinsic and common pathways of coagulation, which are mainly dependent on factors VIII, IX, XI, and XII.

These factors are not inhibited by warfarin.

aPTT is used to monitor the effect of heparin, a direct antithrombin agent that inhibits thrombin and factor Xa.

Choice D is wrong because platelet count is not affected by warfarin.

Platelets are cell fragments that adhere to damaged blood vessels and form aggregates to initiate hemostasis.

Platelet count can be decreased in conditions such as immune thrombocytopenia (ITP), heparin-induced thrombocytopenia (HIT), or bone marrow suppression.