From the Guidelines
A comprehensive nursing service plan for a visually impaired individual using a white cane should prioritize promoting independence while ensuring safety, as emphasized in the vision rehabilitation preferred practice pattern 1, 2, 3, 4.
Signs/Symptoms
Signs and symptoms to monitor include:
- Changes in vision
- Headaches
- Eye pain
- Redness
- Discharge
- Increased difficulty navigating familiar environments, as these may indicate worsening vision or other complications 4 ### Look for and Call the RN On-Call Look for and call the RN on-call if the individual:
- Experiences minor injuries from navigation difficulties
- Shows signs of depression or social isolation
- Has difficulty with medication management
- Demonstrates declining ability to perform activities of daily living 1, 3 ### Call 911 and Notify the RN Call 911 and notify the RN if the individual:
- Experiences sudden vision loss
- Severe eye pain
- Head injury from a fall
- Any medical emergency requiring immediate attention 5 ### Actions to Take Actions to take include:
- Conducting a thorough home safety assessment to remove hazards and improve lighting
- Establishing consistent organization of personal items
- Implementing tactile markers for medication management
- Providing orientation to new environments
- Teaching proper white cane techniques
- Connecting the individual with vision rehabilitation services
- Encouraging regular eye examinations
- Documenting all observations and interventions, as these interventions can significantly improve the individual's quality of life and autonomy 2, 3, 4
From the Research
Signs/Symptoms
- Visually impaired individuals with a white cane may exhibit signs of difficulty navigating their environment, such as hesitancy or uncertainty when encountering obstacles 6
- They may also display symptoms of anxiety or depression, such as irritability, anger, or aggression, which can be related to their visual impairment or other underlying conditions 7, 8, 9
- Cognitive impairment, including difficulties with executive function and memory, may also be present in individuals with traumatic brain injury 8
Look for and Call the RN on-call
- If the individual exhibits signs of distress, such as increased anxiety or depression, or if they are experiencing difficulties with navigation or daily activities 7, 8, 9
- If the individual's white cane is not functioning properly or if they are having trouble using it effectively 6, 10
- If the individual is experiencing any changes in their physical or emotional condition that may require medical attention
Call 911 and Notify the RN if
- The individual is experiencing a medical emergency, such as a fall or injury, that requires immediate attention
- The individual is exhibiting severe symptoms of anxiety or depression, such as suicidal ideation or intent 7, 8, 9
- The individual's condition is deteriorating rapidly and requires immediate medical attention
Actions to Take
- Provide emotional support and reassurance to the individual, and encourage them to express their feelings and concerns 7, 8, 9
- Assist the individual with navigation and daily activities as needed, and provide guidance on the use of their white cane 6, 10
- Encourage the individual to participate in activities that promote cognitive function and overall well-being, such as exercise or social engagement 8
- Collaborate with the RN and other healthcare professionals to develop a comprehensive plan of care that addresses the individual's physical, emotional, and cognitive needs 7, 8, 9