Question

Your 87 year old patient reports that she lives independently, works part time and takes public transportation to work as she stopped driving a year ago. She uses bilateral hearing aides and glasses. She is being prepared for a lumpectomy and node dissection under general anesthesia. Her daughter is her medical power of attorney and is with her in the preoperative area. It is most appropriate to:

A Leave her glasses and hearing aides in place throughout the perioperative process. There is no need to remove them.
B Explain all that will happen in surgery before her hearing aides and glasses are stored safely in a locker to prevent loss or damage.
C Allow her to keep her glasses and hearing aides on until immediately before she is anesthetized.
D Give the patient's hearing aides and glasses to her daughter and then allow her daughter to stay with her until she is anesthetized to answer any questions for her mother.

Answer 1

It is most appropriate to let the patient keep her glasses and hearing aids on until immediately before anesthesia. This allows for clear communication and understanding during preoperative preparations. Sensory aids are safely removed just before the surgery to protect both the patient and the devices.

Step-by-step explanation:

The best approach in this situation with the 87-year-old patient being prepared for a lumpectomy and node dissection under general anesthesia is Option C: Allow her to keep her glasses and hearing aides on until immediately before she is anesthetized. This approach ensures that the patient can communicate effectively and understand all information during the preoperative process. It is important for patient autonomy and comfort that she has the use of her sensory aids as long as possible. However, to ensure the safety of the devices and the patient during surgery, these items will be removed just before anesthesia is administered. The surgeon, nurse, and anesthesia professional will review aloud the key concerns for the recovery and care of the patient, which can take place while the patient still has full use of her sensory aids for clarity and understanding.

As for the question related to cataract surgery, when an intraocular lens (IOL) is placed during cataract surgery, if it is chosen to give perfect distant vision, the person might still need glasses for reading or close work. If the person was nearsighted before the surgery, meaning they had difficulty seeing far away, the power of the intraocular lens would be less than the removed lens to correct this refractive error.