MEDICAL SURGICAL NURSING II

NURSING CARE FOR PATIENTS WITH CATARACTS

MEMBERS OF THE GROUP:

1. Abilla Almubaroqah P01720322050

2. Alda Bhumi Nauli Batubara P01720322001
3. Andara Meilia Selviana P01720322055
4. Annisaa'Hidayah P01720322060
5. Della Vanessa Agustin P01720322010
6. Diva Mahardika Putri P01720322067
7. Dyah Endang Kusuma P01720322068
8. Febrian Sampirgo P01720322015
9. Firery Putra Erlanza P01720322017
10. Fitrotin Nufus P01720322073
11. Indo Putra Ali Dayanto P01720322021
12. Inka Fitri Sona P01720322075

SUPERVISOR :

NS. Andhita Ratnadhiyani, M.Kep., Sp.Kep.MB

MINISTRY OF HEALTH OF THE REPUBLIC OF INDONESIA

HEALTH POLYTECHNIC MINISTRY OF HEALTH BENGKULU
ACADEMIC YEAR 2024/2025
 FOREWORD
The author praises the presence of Almighty God, because of His mercy and
grace, the author was able to complete the Medical Surgical Nursing Paper with the
title "Nursing Care for Cataracts".
In preparing this paper, the author received guidance and assistance, both
material and advice, from various parties so that the author could complete the paper
on time. Therefore, the author would like to thank:
1. NS. Sahran, M.Kep as Coordinating Lecturer for Medical Surgical Nursing
Courses.
2. NS. Andhita Ratnadhiyani, M.Kep., Sp.Kep.MB as the supervisor of the Medical
Surgical Nursing course who has provided guidance and direction to us.
3. Friends who have contributed thoughts, materials and enthusiasm to the author.

The author is fully aware that in preparing this paper there were still many
mistakes and oversights both in terms of writing and preparation and methodology.
Therefore, the author hopes for suggestions and guidance from various parties so that
the author can work better and more optimally in the future.
The author hopes that the report that the author has prepared will be useful for
all parties and can bring positive changes, especially for the author himself and other
students.
Bengkulu, April 25 2024

Writer

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 LIST OF CONTENTS

FOREWORD ................................................................................................................ i
CHAPTER I INTRODUCTION............................................................................... 1
A. Background ......................................................................................................... 1
B. Problem Formulation ......................................................................................... 3
C. Goals .................................................................................................................... 3
CHAPTER II REVIEW OF THEORY ..................................................................... 5
A. Disease Concept ................................................................................................ 5
1 Definition ....................................................................................................... 5
2 Etilogy ............................................................................................................ 6
3 Clinical Manifestations ................................................................................ 7
4 Pathophysiology ............................................................................................ 8
5 Complications ............................................................................................... 9
6 Supporting investigation .............................................................................. 9
7 Management ................................................................................................ 10
B. Nursing Care Concept ................................................................................... 11
1. Assessment ...................................................................................................... 11
2. Nursing diagnoses .......................................................................................... 15
3. Nursing Intervention...................................................................................... 16
4. Nursing Implementation ................................................................................ 22
5. Nursing evaluation ......................................................................................... 22
CHAPTER III CLOSING ................................................................................... 23
BIBLIOGRAPHY ................................................................................................. 24

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 CHAPTER I
INTRODUCTION

A. Background
Cataract is a condition where the lens of the eye which is usually clear
and transparent becomes cloudy (Budiono, 2019). Cataracts are the main
cause of blindness and are a degenerative disease, but currently cataracts are
found at young ages (35-40 years), this is due to a lack of nutritional intake
and nutrition that the body needs (Srinayanti et al., 2017).

The World Health Organization (WHO) found that there are 285
million people who experience visual impairment in the world, 39 million are
blind and 246 million have low vision (Syarifah, 2019). The prevalence of
cataracts in Indonesia based on the 2018 Riskesdas results is 1.8%. The
highest prevalence of cataracts is in North Sulawesi (3.7%), Jambi (2.8%) and
Bali (2.7%) (Ministry of Health, 2018). The results of the Rapid Assessment
of Avoidable Blindness (RAAB) survey by the Association of Indonesian
Ophthalmologists (Perdami) and Balitbangkes in 2019 in 15 provinces
revealed that the blindness rate was found to have reached 30% and of this
figure, cataracts were the highest cause, namely 81% (Ariyanto, 2019 ).The
number of cataract patients who visit the Bali Mandara Eye Hospital each
year has increased, namely in 2019 there were 1,251 people, in 2020 there
were 1,428 people. When viewed from the age group, cataract sufferers are
mostly found in patients aged over 50 years, namely the age range 60-75 years
(67.8%) (Bali Mandara Eye Hospital, 2021).

Blindness that occurs due to cataracts can be prevented with surgery.

Surgery for cataract patients aims to improve vision or sharp vision. Cataract
surgery is performed by removing the eye lens affected by cataracts and then

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replacing it with an implant lens or Intraocular Lens (IOL). More than 90% of
cataract operations are successful with improvements in visual function as
expressed by improvements in the patient's vision after surgery. Most patients
achieve good category vision, namely 6/18-6/6 after four to eight weeks after
surgery (Ilyas, 2013). The problem that arises today is cataract patients who
do not undergo surgery, this is caused by many factors. The results of the 2018
Bali Riskesdas show that one of the main reasons cataract patients have not
undergone cataract surgery is fear of undergoing surgery (40.1%) (Bali
Provincial Health Service, 2020).

Operation (surgery) causes a crisis situation, namely internal

disturbances caused by events that are stressful, threatening and increase
anxiety (Hawari, 2013). Surgery is an actual potential threat to integrity that
can evoke physiological and psychological stress reactions. Surgery is a form
of therapy that can pose a threat, both potential and actual, to a person's body,
integrity and soul which can trigger anxiety in the patient (Srinayanti et al.,
2017).

The results of research conducted by Ariyanto (2019) entitled The

Relationship between Anxiety Levels and Coping Mechanisms for Pre-
Cataract Surgery Patients at the Eye Clinic, Level III Baladhika Husada
Jember Hospital in 2019, showed that the highest anxiety level value was
moderate anxiety level, 44 people (45.8 %). Research conducted by Syarifah
(2019) on Identification of Anxiety Responses in Pre-Cataract Surgery
Patients in Jember Regency in 2019 also showed that the level of anxiety
experienced by pre-cataract surgery patients was 51 people (42.5%) patients
experienced mild anxiety, 33 people (27, 5%) had no anxiety, 32 people
(26.5%) experienced moderate anxiety and 4 people (3.3%) experienced
severe anxiety.

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 The impacts caused by anxiety before surgery include changes in the
body's hemodynamics such as blood pressure, pulse and respiratory rate
which can confuse the medical team about continuing the operation. If anxiety
in pre-operative patients is not addressed, it can interfere with the operation
process and the patient's healing. Efforts to maintain the psychological
condition of patients who will undergo surgery, so as not to hinder or disrupt
the patient's surgery and treatment process (Ariyanto, 2019).

B. Problem Formulation
1) What is the definition of cataract?
2) What is the etiology of cataracts?
3) What is the pathophysiology of cataracts?
4) What are the clinical manifestations of cataracts?
5) What complications can occur in cataract sufferers?
6) What are the supporting examinations for cataract sufferers?
7) How are cataract sufferers treated?
8) What is nursing care for cataract sufferers?

C. Goals
1. General purpose

Able to know and apply the concept of nursing care with a

comprehensive medical surgical nursing process approach with cataract
nursing care.

2. Special purpose

a. To find out what is meant by cataracts

b. To find out what the etiology of cataracts is
c. To find out what the classifications of cataracts are
d. To find out the pathophysiology of cataracts

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e. To find out what the clinical manifestations of cataracts are
f. To find out the diagnostic examination for cataracts
g. To find out complications from cataracts
h. To find out how to carry out cataract investigations
i. To find out how nursing care for cataracts is

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 CHAPTER II
REVIEW OF THEORY

A. Disease Concept
1 Definition

Cataract comes from the Greek katarrhakies, English cataract, and

Latin cataracta which means waterfall. In Indonesian it is called bular
where the vision is like being covered by a waterfall. Cataract is a
clouding of the lens which leads to a decrease in visual acuity and/or
functional disability felt by the patient (Khalilullah, 2010). Cataract
comes from the Greek word Katarrahakies, the English Cataract, and the
Latin word Cataracta which means waterfall. In Indonesian it is called
bular, where the vision is like being covered by a waterfall due to a
cloudy lens. Cataracts can occur due to hydration, protein denaturation or
both (protein denaturation or both (Handayani, 2011).
A cataract is a clouding of the lens or lens capsule that changes the
image projected on the retina. Cataracts are a common cause of gradual
vision loss. gradually. (Springhouse (Springhouse Co, 1997). The degree
of disability resulting from cataracts is influenced by the location and

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 density of the blurriness. Intervention is indicated if vision decreases to
the point that the client cannot accept change and is detrimental or affects
the client's lifestyle (ie vision 5/15 ). Cataracts usually affect both eyes.
Cataracts usually affect both eyes but each develops independently.
Exceptions, traumatic cataracts are usually unilateral and congenital
cataracts are usually stationary (Istiqomah, 2012).
Cataract is any condition of clouding of the lens which can occur due
to hydration (addition of lens fluid), denaturation of lens proteins or both.
Usually the clouding affects both eyes and is progressive or may not
change for a long time. (Tamsuri, 2011) Cloudiness of the lens will
prevent light from entering the eye, resulting in decreased vision. Lens
protein clumps result in reduced sharpness b reducing the sharpness of the
image reaching the retina. The phantom gums reach the retina. Small clots
that are not too small do not interfere with vision and these clots increase
in vision and these clots increase in size until they are so big that slowly
vision becomes less and less visible. Cataracts are included in the
category of blindness that cannot be prevented, blindness that cannot be
prevented and can be cured. (Main, 2014)

2 Etilogy
The following are several causal factors (etiology) of cataracts (Ilyas.
2014):
a. Age
Cataracts generally occur due to the aging process. The number of
cataract sufferers is directly proportional to the number of elderly
people. The aging process causes the eye lens to become hard and
cloudy, generally occurring over the age of 50 years.
b. Eye Trauma

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 Eye trauma accounts for a large part of the increase in the number of
cataract sufferers. Cataracts occur due to eye trauma and can occur at
any age. Trauma or injury to the eye results in erosion of the
epithelium in the lens. In this situation, hydration of the cortex can
occur until the lens bulges and becomes cloudy.
c. Diabetes mellitus
Diabetes mellitus also contributes to the high number of cataract
sufferers, in line with the increasing number of cases of diabetes
mellitus sufferers. Cataract formation associated with diabetes often
occurs due to excess levels of sorbitol (a sugar formed from glucose),
which forms a buildup in the lens and ultimately forms lens
cloudiness.
d. Hypertension.
Hypertension plays an important role in the development of cataracts.
Hypertension can cause changes in the structural conformation of
proteins in the lens capsule, which can trigger cataracts.
e. Genetics
Genetic or hereditary factors are one of the factors that cause
cataracts. Because some inherited genetic disorders can cause other
health problems that can increase the risk of cataracts, such as
chromosomal abnormalities that can affect the quality of the eye lens,
which can trigger cataracts.

3 Clinical Manifestations
Sufferers can experience several signs and symptoms, for example:
1) Vision/eyesight is blurry, gloomy or as if there is a shadow of clouds
or smoke
2) There is a white circle when looking at the light
3) Needs bright light for reading or when doing activities

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 4) It's hard to see at night
5) The vision is getting blurry, even though I change the size of the
glasses.
6) Frequently changing glasses or contact lenses due to discomfort
7) The eyes become very sensitive to light (glare)
8) Double vision or multiple images in one eye (this symptom can occur
when the cataract of the eye (this symptom can occur when the
cataract gets bigger)
9) Color fades or tends to yellow

4 Pathophysiology
The normal lens is the posterior structure of the iris which is clear,
transparent, shaped like a shirt button and has great refractive power. The
lens contains three anatomical components. In the central zone there is the
nucleus, in the periphery there is the cortex, and what surrounds them are
the anterior and posterior capsules. With increasing age, the nucleus
changes color to yellowish brown. Around the opacity there is a spine-like
density anterior and posterior to the nucleus. Opacity in the posterior
posterior capsule is the most significant form of cataract, meaning it looks
like snow crystals on the window (Ilyas, 2008).
Physical and chemical changes in the lens result in loss of
transparency. Changes in the multiple fine fibers (zunula) that extend
from the ciliary body to the area outside the lens, for example, can cause
vision to experience distortion. Chemical changes in lens proteins can
cause coagulation, clouding vision by blocking the passage of light to the
retina. One theory is that the breakdown of normal lens proteins occurs
accompanied by an influx of water into the lens. This process breaks tense
lens fibers and disrupts light transmission. Another theory says that an
enzyme plays a role in protecting the lens from degeneration. The amount

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 of enzymes will decrease with increasing age and is absent in most
patients suffering from cataracts (Ilyas, 2008).

5 Complications
If cataracts are not treated they can make vision blurry, it is harder to
see in bright light or at night, and colors may appear duller than before. If
left untreated, cataracts can cause blindness. Complications that can arise
after surgery are relatively low. However, if cataract surgery or lens
clouding experiences complications, there may be partial or total vision
loss.
1) Glaucoma (blindness)
2) Uveitis (inflammation of the uvea or middle layer of the eye)
3) Corneal endothelial damage (swelling of the cornea)
4) Pupillary blockage
5) Stosoid macular edema (swelling and fluid in the central layer of the
optic nerve)
6) Endophthalmitis (severe inflammation that occurs in all intraocular
tissue that affects the walls of the eyeball, namely the retina and
choroid or eye infection).
7) Choroidal detachment
8) Bleeding (bleeding in the eye)

6 Supporting investigation
Supporting examinations for cataract patients according to (Brunner
and Suddarth) are:
1) Visual examination: Depending on the location and stage of cataract
maturation, visual acuity can range from 6/9 to only light perception.
2) Oblique illumination examination: This examination is to see the
color of the lens around the pupil which can vary in various types of
cataracts.

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 3) Snellen eye card / telebinocular machine, (visual acuity test and
central vision)
4) Ophthalmoscopic examination.
a. Slit lamp examination: Seeing the type and extent of Slit lamp
examination: Seeing the type and extent of lens changes
b. Direct Ophthalmoscopy: red reflex is absent/not clear
5) Iris shadow test: The purpose of the shadow test is to determine the
degree of lens cloudiness.
The basis for the examination is that the less cloudy the lens is in the
posterior part, the larger the iris image in the cloudy lens, while the
thicker the lens opacities, the smaller the iris image in the lens.
a. If the image of the iris in the lens looks large and is located far from
the pupil, it means that the lens is not completely cloudy (has not
reached the front); This occurs in immature cataracts, this condition
is called shadow test (+).
b. If the image of the iris on the lens is small and close to the pupil, it
means that the lens is completely cloudy (up to the anterior capsule),
which is a mature cataract, this condition is called a shadow test (-).
c. If the cataract is hypermature, the lens is completely cloudy, smaller
and located far back, so that the image of the iris on the lens is large
and this condition is called pseudopositive.

7 Management
If cataracts are not too bothersome, just wearing new glasses will help
you see better. If cataracts cause worsening vision and make it difficult to
carry out daily activities, a surgical procedure is a treatment that can be
done to treat cataracts.
Cataract surgery is generally safe and does not require hospitalization.
There are two types of cataract surgery, namely:

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 1) Small incision cataract surgery (phacoemulsification). This operation
is performed by making a small incision on the edge of the cornea.
Next, the doctor will shine ultrasound waves to destroy the lens and
then take it out using a suction tool.
2) Extracapsular surgery. This operation requires a larger incision to
remove the cloudy lens core. Next, the remaining lens is removed
using a suction tool.

B. Nursing Care Concept

According to Potter (2021) the nursing care process consists of five stages which
include:

1. Assessment
Assessment is the collection of subjective and objective information,
reviewing patient history information provided by the patient/family, or found in
medical records.
a. Identity
1) Patient identity: name, age, gender, ethnicity, religion, occupation, education,
address.
2) Identity of the person in charge: name, age, gender, occupation, address,
relationship with the patient, religion.
b. Main complaint
Complaints reported or found include continuing to ask questions regarding
surgery, appearing restless, shaking, sweating, palpitations and frequent urination.
c. Historyhealth now
History related to current problems faced during hospitalization.
d. Historyhealth first

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 Whether the client has ever been treated for the same disease or not. whether
the client goes home healthy or still sick. whether the client has a history of chronic
disease or not.
e. Historyfamily health
Does the family have a history of the same disease as the client currently
suffering from? History of hereditary diseases such as hypertension, DM, heart
disease.
f. Historymedication and allergies
What medications does the client often take, does the client have allergies or
not to drugs, food and insects.
g. Patterngordon function
1) Maintenance and perceptions of health
Assess the client's knowledge about his illness, when the client is sick, what
actions the client takes to support his health.
2) Nutrition/metabolic
Assess the food consumed by the client, portions per day, types of food, and
volume of drinks per day, favorite foods before being in hospital and during
hospitalization.
3) Elimination pattern
Assess the frequency of defecation and urination, whether there is pain or not
during defecation and color
4) Activity and exercise patterns
Assess the client's ability to carry out activities and be able to carry out
activities independently, with assistance or using tools such as eating and drinking,
bathing, toileting, dressing and moving. (0: Independent, 1: Tools, 2: Helped by other
people, 3: Helped by other people and tools, 4: Totally dependent).
5) Sleep and rest patterns
Assess rest patterns, quality and quantity of sleep, if disturbed, assess the
cause

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 6) Cognitive-perceptual patterns
Client's mental status, assess understanding of illness and treatment
7) Patterns of self-perception
Self-perception patterns need to be studied, including; self-esteem, self-ideal,
self-identity, self-image.
8) Sexual and reproductive patterns
Assess menopause, assess sexual activity
9) Roles and relationship patterns
Aims to find out roles and relationships before and after illness. Changes in
the usual pattern of responsibilities or changes in physical capacity to carry out the
role
10) Stress coping management
There are old stress factors, the effects of hospitalization, financial problems,
housing, communication patterns to solve problems
11) Patterns of beliefs and values
Explain the client's attitudes and beliefs in implementing the religion he
adheres to and the consequences in everyday life. With this, it is hoped that nurses
will provide motivation and approach to clients in their efforts to carry out worship
h. Physical examination
A complete general examination needs to be carried out. Elderly people with
cataracts will focus on the eyes. The results of the physical examination that need to
be considered are as follows:
1) Head and face
Inspection: Head symmetrical left and right, no enlargement of the head. Normal
head size for age. The face is usually not symmetrical left and right, the face looks
pale.
Palpation: no pain in the head
2) Eye

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Inspection: Pupils are equal, round, reactive to light and accommodation, conjunctiva
anemic, sclera not icteric. The eyes appear symmetrical on the left and right, there is
cloudiness in the lens, there is a decrease in the visual field
Palpation: no swelling of the eyes
3) Ear
Inspection: Symmetrical left and right ears, looks clean without cerumen. The ears
appear symmetrical on the left and right, there is no visible swelling.
Palpation: There is no pain in the earlobe, there is no swelling in the earlobe.
4) Nose
Inspection: Symmetrical left and right nose, not visible. The nose looks symmetrical,
there is no bleeding, there are no polyps. There is a decrease in the ability to smell,
bleeding in the nose.
Palpation: No pain when touched on the nose, no swelling.
5) Mouth
Inspection: Mucous membranes are pink, moist, and intact. Uvula in midline, No
lesions. The mouth looks dirty, there is bad breath. Palpation: There is no pain in the
mouth, no swelling in the mouth
6) Neck
Inspection: The position of the trachea is tilted or not, the jugular vein is not visible,
Palpation: No palpable nodules on the neck, no swelling, whether there is
enlargement of the thyroid gland or lymph nodes or not
7) Lungs
Inspection: Symmetrical left and right, no lesions, presence or absence of chest
retraction, no use of accessory muscles for breathing
Auscultation: Vesicular in both lung fields. Percussion: Sound in both lung fields
Palpation: There is movement of the chest wall, tactile fremitus is clearly palpable
8) Heart
Inspection: Ictus cordis is visible or not, lesions in the heart area or not, swelling of
the heart or not

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Palpation: In the area of ICS II, left ICS V, and midclavicular area to determine the
boundaries of the heart, there is no enlargement of the heart
Percussion: Faint
Auscultation: Normally heart sound 1 is higher than heart sound II, there are no
additional sounds such as mur-mur. S2 (dub) is heard in ICS II when the aortic and
pulmonary valves close at the beginning of systole, a split is heard which results in
two valve sounds , this is due to different aortic and pulmonary closure during
respiration. S1 (lub) is heard on ICS V when the mitral valve and tricuspid valve
close at the start of systole. It is heard well at the apex of the heart and is heard with
the stethoscope diaphragm where it is heard simultaneously.
9) Abdomen
Inspection: no swelling of the abdomen/ ascites Palpation: no distension of the
abdomen
Percussion: Tympani
Auscultation: normal bowel sounds
10) Extremities
Inspection: no swelling in the upper and lower extremities, no wounds
Palpation: good muscle strength in all extremities

2. Nursing diagnoses
Nursing diagnosis is a clinical assessment of the client's response to the health
problems or life processes they are experiencing, both actual and potential, which
aims to identify the response of individual clients, families and communities to
situations related to health.

The priority nursing diagnosis that is thoroughly discussed in this scientific work is
anxiety which can be presented in the following table (PPNI, 2016)

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 3. Nursing Intervention
Planning is the next step after establishing a nursing diagnosis. In this step, the nurse establishes goals and criteria
for expected outcomes for the patient and plans nursing interventions. Preparation of nursing interventions based on the
Indonesian Nursing Intervention Standards (SIKI). Planning that can be carried out for patients with a nursing diagnosis of
anxiety can be described as follows (PPNI, 2016):

No Nursing diagnoses Objectives and Result Nursing Intervention Rationalization

Criteria
1 Anxiety related to After being given 3x24 Siki: Anxiety Reduction 1. to determine the level of pain, pain
situational crisis hour nursing care is Observation conditions and stressors
expected 1. Identify when anxiety 2. to determine decision-making
SLKI:Anxiety levels levels change (e.g. ability
decrease conditions, time of day, 3. to determine the patient's vital signs
With result criteria: stressors) 4. so that the patient is comfortable
a. Verbalization of 2. Identify decision-making and relaxed
confusion decreases abilities 5. so that the patient is comfortable
b. Anorexia decreases 3. Monitor for signs of and relaxed
c. Palpitations anxiety (verbal and non- 6. so that patients tell stories and
decreased verbal) provide motivation to clients
d. Tremors decreased Therapeutic 7. to determine patient anxiety
e. Decreased pallor 4. Create a therapeutic 8. so that patients want to tell stories

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f. Sleep patterns atmosphere to foster trust to motivate clients
improve 5. Accompany the patient to 9. so that you understand the side
g. Concentration reduce anxiety, if possible effects of the drug
improves 6. understand the situations 10. so that the patient is relaxed and
h. Pulse frequency that create anxiety comfortable
improves 7. listen attentively
Blood pressure 8. Use a calm and reassuring
improves approach
Education
9. Explain the procedure,
including any sensations
you may experience
10. provide factual information
regarding diagnosis,
treatment and prognosis
11. recommend taking non-
competitive actions as
needed
12. practice deep breathing

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 relaxation techniques
1. Collaborative
administration of anxiety
medication, if necessary

2. Acute Pain b,d Physical After carrying out nursing SIKI: Pain Management
Injury Agents procedures for 3 x 24 Nursing Activities:
hours, it is expected that Observation Observation
you will be able to: 1. Identify location, 1. Pain is a subjective experience and
Pain Level characteristics, duration, must be described by the client to
Expectations:Decrease frequency, quality, plan effective treatment
intensity of pain 2. The pain scale is used to determine
With Result Criteria: 2. Identify the pain scale the severity of the pain experienced
1. Pain complaints 3. Identify non-verbal pain by the client
decreased responses 3. To determine the level of
2. Difficulty sleeping 4. Identify factors that discomfort felt by the client during
decreases aggravate and relieve pain the recovery process, usually the
3. Decreased anxiety Therapeutic client will be restless, difficult to
4. The perineum feels 5. Provide non- focus, facial expression grimacing

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 depressed pharmacological 4. To find out the factors that
5. Blood pressure techniques to reduce pain aggravate and relieve the pain you
improves (eg. TENS, hypnosis, feel
6. Urinary function acupressure, music 5. Reduces the patient's pain
improves therapy, biodeedback, level/distracts the patient from the
massage therapy, pain and provides a relaxing effect
aromatherapy, guided 6. Reduce risk factors that can
imagery techniques, warm aggravate pain/cause pain
or cold compresses, play 7. Divert and fulfill the patient's rest
therapy) needs
6. Environmental controls 8. Provide information related to the
that aggravate and relieve pain felt by the patient
pain (e.g. room 9. Can help clients and families with
temperature, lighting, the importance of information on
noise) controlling pain and finding family
7. Facilitate rest and sleep support
Education 10. Providing non-pharmacological
8. Explain the causes of techniques can help clients
periods and pain triggers understand pain anxiety

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 9. Explain pain relief 11. Giving analgesics can relieve or
strategies eliminate pain in the body
10. Teach non-
pharmacological
techniques to reduce pain
Collaboration
Collaborative administration of
analgesics, if necessary
3. Risk of infection related After carrying out nursing SIKI:Infection Prevention 1. Know the signs of infection early
to the effects of intervention for 3x24 2. Reduce exposure to viruses/germs
invasive procedures hours, it is hoped that the Nursing Activities that enter the client's body
client will be able to SLKI: Observation: 3. To prevent infection
Infection Level 1. Monitor for signs and 4. To prevent infection
Expectations: Decreased symptoms of local and 5. Antibiotics in babies can help the
By Result Criteria: systemic infection healing process caused by bacteria
9) Increased appetite Therapeutic:
10) Improved body 2. Limit the number of
hygiene visitors
11) Redness decreases 3. Wash hands before and

20
 after contact with patients
and the patient's
environment
4. Maintain aseptic
technique in high-risk
patients
Collaboration :
5. Collaborative
administration of
antibiotics, if necessary

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4. Nursing Implementation
Nursing implementation or implementation is a component of the nursing process
which is a category of nursing behavior in which the actions necessary to achieve the
goals and expected results of nursing care are carried out and completed. This
understanding emphasizes that implementation is carrying out or completing an
action that has been planned at a previous stage (PPNI, 2016).

The main implementation highlighted in this report is the provision of relaxation

techniques (Benson relaxation) as an effort to reduce anxiety in the elderly before
undergoing surgery.

5. Nursing evaluation
Evaluation is the final stage of the nursing process which aims to assess the
success of the nursing actions that have been implemented and the client's progress
towards achieving goals. Evaluation of nursing care is based on the Indonesian
Nursing Outcome Standards (SLKI), where this standard explains the definition and
criteria for targeted nursing outcomes in accordance with the nursing diagnosis
adopted (PPNI, 2016).

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 CHAPTER III
CLOSING
A. CONCLUSION

Cataract is any condition of clouding of the lens which can occur

due to hydration (addition of lens fluid), denaturation of lens proteins
or both. Usually the clouding affects both eyes and is progressive or
may not change for a long time. Several causal factors (etiology) in
cataracts, age, eye trauma, diabetes mellitus, hypertension, genetics. .
Nursing diagnoses that arise in patients who have cataracts and will
undergo surgery include: Anxiety related to a situational crisis, worry
about failure and threats to health status, Acute pain related to
physiological, physical and chemical injurious agents, Risk of
infection related to the effects of invasive procedures .

B. SUGGESTION

By writing this paper, the author hopes to increase knowledge

for readers. However, in his description, the author is aware that
there are still many things that are lacking, therefore the author
hopes that all readers can provide constructive criticism and
suggestions.

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