Case Study, Chapter 16, Assessing Eyes

The nurse is conducting a distance vision acuity test for James Adamson, a 55-year-old male

client who has come in for an eye exam. Mr. Adamson has a history of hypertension (HTN) for

12 years and juvenile diabetes since age 8. He wears glasses. He takes medication for the HTN

and insulin for the diabetes. He states that he takes his medication as prescribed, but his blood

pressure has been higher than usual lately. He has had “very bad” headaches for the past few

weeks, and his vision has become blurred. He has been having difficulty driving, especially at

night. The nurse positions the client 20 ft away and instructs him to remove his glasses and read

the Snellen chart. The client leans forward to read the chart. The nurse notes that the client is

able to read until the fifth line in the Snellen chart and documents vision as 20/50.

(Learning Objectives: 1, 2, 3, 4)

Questions:

a. Given the client’s age and medical history, what changes would you expect to find
during the eye exam?

b. When conducting the health assessment, what information would be important for the
nurse to obtain?