Home Health Teaching

Vacuuming should be avoided because of the forward flexion and rapid, jerky movement required. Driving, sports, and machine operation can be resumed when permission is granted by the eye surgeon.

Clients fitted with cataract eyeglasses need information about altered spatial perception. The eyeglasses should be first used when the patient is seated, until the patient adjusts to the distortion. Instruct the client to look through the center of the corrective lenses and to turn the head, rather than only the eyes, when looking to the side. Clear vision is possible only through the center of the lens. Hand-eye coordination movements must be practiced with assistance and relearned because of the altered spatial perceptions.

Cerebral Aneurysm

DRG Category: 014

Mean LOS: 6.4 days

Description: MEDICAL: Specific Cerebrovascular,

Except TIA DRG Category: 001 Mean LOS: 9.6 days Description: SURGICAL: Craniotomy, Age > 17, Except for Trauma

Ce erebral aneurysm is an outpouching of the wall of a cerebral artery that results from weakening of the wall of the vessel. It is difficult to determine the frequency of cerebral aneurysms because of differences in the definitions of the size of aneurysm and the ways that aneurysms are

200 Cerebral Aneurysm detected. The prevalence is estimated to range from 5% to 10%; unruptured aneurysms account for approximately 50% of all aneurysms.

Cerebral aneurysms have a variety of sizes, shapes, and causes (Table 4). Most cerebral aneurysms are sacular or berry-like with a stem and a neck. The incidence of cerebral aneurysm has been estimated at 10 per 100,000 per population, with approximately 15% to 25% of patients having multiple aneurysms, often bilateral in the same location on both sides of the head. Clinical concern arises if an aneurysm ruptures or becomes large enough to exert pressure on surrounding structures. When the vessel wall becomes so thin that it can no longer withstand the surrounding arterial pressure, the cerebral aneurysm ruptures, causing direct hemorrhaging of arterial blood into the subarachnoid space (subarachnoid hemorrhage).

• TABLE 4 Classification of Cerebral Aneurysms

Size

Small, <15 mm

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