Nokea
A client is admitted to the health care facility with acute glaucoma. After administering the prescribed ophthalmic drugs, the nurse continues to assess the client for pain relief at which frequency?
- A. Every hour
- B. Every 2 hours
- C. Every 3 hours
- D. Every 4 hours
Correct Answer: B
Rationale: Clients admitted for treatment of acute glaucoma should be assessed every 2 hours for relief of pain. Pain in the eye may indicate increased intraocular pressure.
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The ophthalmic preparation erythromycin (Ilotycin) is contraindicated in clients with which of the following? Select all that apply.
- A. Gonorrheal infection of the eye
- B. Varicella infection of the eye
- C. Fungal infection of the eye
- D. Epithelial herpes simplex keratitis of the eye
- E. Mycobacterial infection of the eye
Correct Answer: B,C,D,E
Rationale: Antibiotic ophthalmic preparations, like erythromycin (Ilotycin), are contraindicated in clients with the following: epithelial herpes simplex keratitis, varicella, mycobacterial, and fungal infections of the eye.
A nurse is caring for a patient who is prescribed 1% hydrocortisone/4.71 mg neomycin (Coly-Mycin S Otifor bacterial infections of the external auditory canal. Which of the following instructions should be followed by the nurse administering the otic solution?
- A. When the patient is upright, remove the solution running out of the ear with gauze.
- B. After instilling the drops, insert a cotton piece deep into the ear to keep the drops in.
- C. Keep the patient lying on the untreated side for 30 minutes after instilling the drops.
- D. Insert the applicator or dropper tip sufficiently to reach into the external auditory canal.
Correct Answer: A
Rationale: Once the patient is upright, the solution running out of the ear may be gently removed with gauze. A piece of cotton can be loosely inserted into the ear canal, but it should never be inserted deeply because if inserted too deeply it may cause increased pressure within the ear canal. The patient is kept lying on the untreated side after the medication is instilled for approximately 5 minutes to facilitate the penetration of the drops into the ear canal. The nurse should not insert the applicator of dropper tip anywhere into the ear or allow the tip to become contaminated.
A client receiving ophthalmic drugs reports blurred vision. He tells the nurse, 'I almost fell yesterday.' The nurse identifies which nursing diagnosis?
- A. Risk for Infection
- B. Risk for Injury
- C. Acute Pain
- D. Anxiety
Correct Answer: B
Rationale: The client's complaint of blurred vision and his report of almost falling support the nursing diagnosis of Risk for Injury. Risk for Infection would be appropriate if the client had an infection or did not correctly instill the eyedrops, contaminating the container and/or solution. Acute Pain would be more appropriate if the client complained of pain either from the disorder or as an adverse effect. Although the client may be anxious, there is no evidence to support it.
A client is receiving multiple ophthalmic drugs. Which of the following ophthalmic preparations would the nurse administer to the client for the purpose of treating increased intraocular pressure? Select all that apply.
- A. Brimonidine (Alphagan)
- B. Apraclonidine (Iopidine)
- C. Tobramycin (TobraDex)
- D. Ofloxacin (Ocuflox)
- E. Ganciclovir (Vitrasert)
Correct Answer: A,B
Rationale: Brimonidine (Alphagan) and apraclonidine (Iopidinare ophthalmic preparations used to treat increased intraocular pressure.
A client is prescribed two ophthalmic drugs that are to be administered at about the same time each day. The nurse instructs the client to separate the drug administration by which amount of time?
- A. 1 to 2 minutes
- B. 3 to 5 minutes
- C. 5 to 10 minutes
- D. 10 to 15 minutes
Correct Answer: C
Rationale: If more than one topical ophthalmic drug is being used, the nurse would instruct the client to administer the drugs at least 5 to 10 minutes apart.