Search This Blog

Nursing Care Plan for Child with Disturbed Sensory Perception (visual) related to Retinoblastoma


Retinoblastoma is a tumor of the retina that is composed of undifferentiated neuroblastic cells and is a malignant tumor of the retina in children. 40% of patients with retinoblastoma is herediten disease. Retinoblastoma is a tumor that is autosomal dominant and an embryonal tumor. Most patients with active retinoblastoma discovered at the age of 3 years, while if there is a binocular is usually found at a younger age or 10 months. Retinoblastoma can be found in the form of regression, especially in children.


Nursing Diagnosis and Interventions

Nursing Diagnosis : Disturbed Sensory Perception (visual) related to sensory acceptance of eye disorders.

Nursing Interventions :

Goal Statement (NOC)
  • Maintain visual acuity, without further loss.
  • Define visual acuity, note whether one or both eyes are involved.
Intervention (NIC)
  • Orient the patient to the environment, staff, everyone else in the area.
  • Put the items needed / position call bell within reach.
  • Encourage the client to express feelings of loss / possible loss of vision.
  • Take action to help the patient to deal with limited vision, for example, set furniture / toys, fix gloomy light and night vision problems.
  • Visual acuity can be used to determine visual impairment occurs.
  • Orientation will accelerate the adjustment of patients in the new environment.
  • Facilitate decision-goods if needed.

Rationale :
  • By knowing the patient's expression of feelings can facilitate subsequent nursing actions.

Pediatric Nurses