DQ1
Diana
The Affordable Care Act (ACA) (2010) also known as Obama care brought a revolutionary change in the health policy system in the US. Over the years, the ACA has successfully increased the number of people insured and has provided health insurance to over 20 million people (
Center et al., 2017
). Many such newly insured people only got the opportunity to be insured only because of this act since previous laws barred them from getting medical insurance due to pre-existing medical conditions.
The ACA has also enabled Americans to be more financially secured by protecting them from catastrophic medical bills. The act has also been successful in reducing wealth inequality to a certain extent. The act also helped to lower the deficit in the Congressional budget (
Sanger-Katz, 2017
). However, despite these successes, it has been observed that the ACA failed to provide much support to the middle class and the working class of America. 40% of the American population who earn 400% over the poverty level have not received any benefit from the extended insurance and continue to bear the high cost of healthcare (Center et al., 2017). Moreover, premiums also rose after the implementation of the ACA (Patton, 2020).
Furthermore, the ACA has also failed to reduce the overall cost of health insurance and has also failed to reduce the complexity of the health care system (Sanger-Katz, 2017). I believe that despite its failures and flaws, ACA is a step in the right direction and with little tweaks and improvements in certain areas, the act can indeed achieve what it set out to achieve.
DQ2
Yirlem:
Cataracts
Cataracts is a condition that result from clouding of the eye lens. The symptoms may not affect the visual acuity at first but distort the patient’s vision with time, making objects appear blurred and reducing night vision (Eliopoulos, 2018). Patients with cataracts may also complain of bright light and report seeing objects with small prints. Moreover, the eye lens becomes yellow and eventually changes from black to cloudy white. However, nursing intervention for cataracts includes surgery to remove the lenses and strengthen the existing visual capacity. While surgery is the most common treatment for cataracts, patients with single cataracts may use applicable safety measures to reduce their limitations and improve their visual capacity.
Glaucoma
Glaucoma is another eye disease ranked after cataracts as the most common eye problem. Serener and Serte (2019) state that in the early stages of glaucoma, patients experience no vision loss symptoms. However, the patients may start to have severe eye pain, blurred vision, headache, nausea, and vomiting for acute glaucoma. Conversely, patients with chronic glaucoma are often asymptomatic until advanced stages when they start feeling headaches, cloudy vision, and a tired feeling in the eyes. Treatment for acute and chronic glaucoma includes a combination of miotic and a carbonic anhydrase inhibitor or surgery (Eliopoulos, 2018). Nevertheless, the patient should avoid physical straining and emotional stress to prevent future complications.
Macular Degeneration
Macular degeneration is another eye disease that leads to blindness for older adults over 65 years. Schultz et al. (2021) mention that its symptoms include reduced central vision, inability to see at night, increased visual blurriness, distortion of straight lines and texts, and faded vision color. The loss of central vision can easily lead to blindness. Nonetheless, the nursing intervention for this condition is a routine ophthalmic examination, laser therapy, and recommending magnifying glasses and high-intensity reading lamps (Eliopoulos, 2018). The treatment methods would help prevent additional vision loss for the patients.
Detached Retina
A detached retina is another common condition among older adults. The symptoms include the perception of spots moving across the eye, blurred vision, flashes of light, and a feeling of developing coating over the eye (Eliopoulos, 2018). The conditions may result in complete vision loss according to the severity of the symptoms and retinal detachment. The nursing intervention includes prescribing bed rest and using bilateral eye patches as initial measures. After a maximum retina reattachment, surgery may be planned, such as electrodiathermy, cryosurgery, scleral buckling, and photocoagulation. Evaluation is then done to evaluate the success of the surgery and determine whether a second surgery is required.
Corneal Ulcers
A corneal ulcer is an inflammation of the cornea, commonly caused by injuries, bacterial, fungal, or viral infection. The signs and symptoms of the infection include perforations that destroy the cornea. Besides, the affected eye becomes bloodshot, while the patient feels pain and photophobia. Medical practitioners should advise the patients to seek medical care for irritation, suspected infection, or any problem with the cornea for treatment of any infection or abrasion. Besides, Eliopoulos (2018) mentions that cycloplegics, sedatives, antibiotics, and heat are the common medication prescribed for corneal ulcers. Moreover, the nurse may advise the patient to use sunglasses to reduce the discomfort provided by photophobia. However, a corneal transplant may be applied if the condition is advanced or severe.