Nokea
A client is prescribed an otic agent to promote cerumen removal. Which of the following would the nurse include in the teaching plan? Select all that apply.
- A. Insert a cotton swab into the ear canal at least once a day.
- B. Do not use the drug if there is ear drainage.
- C. Use the drug for no more than 4 days.
- D. Call your primary health care provider if dizziness occurs.
- E. After the treatment, do not flush the ear with warm water to remove remaining wax.
Correct Answer: B,C,D
Rationale: The nurse would instruct the client not to insert anything into the ear canal, such as a cotton swab, not to use the drug if there is ear drainage, to use the drug for no more than 4 days; to call the primary health care provider if dizziness occurs; and to remove any wax remaining after the treatment by gently flushing the ear with warm water using a soft rubber bulb syringe.
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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 educating a client on the use of Acetasol HC otic drops, which contain hydrocortisone, acetic acid, propylene glycol, sodium, and benzethonium chloride. While educating the client, the nurse integrates knowledge that the preparation exerts the action of which of the following? Select all that apply.
- A. Antifungal
- B. Corticosteroid
- C. Antibacterial
- D. Analgesic
- E. Anesthetic
Correct Answer: A,B,C
Rationale: Acetasol HC contains a corticosteroid (hydrocortisone); acetic acid and benzethonium provide antifungal and antibacterial action.
Trifluridine is being administered to a patient who is being treated for epithelial keratitis. The nurse caring for this patient should know that which of the following is a local reaction to trifluridine?
- A. Edema of the eyes
- B. Loss of visual acuity
- C. Cataract formation
- D. Delayed wound healing
Correct Answer: A
Rationale: Trifluridine is an antiviral drug, and administration of antiviral ophthalmics may cause local reactions such as edema of the eyes or eyelids, irritation, pain, pruritus, inflammation, foreign body sensation, and corneal clouding. Loss of visual acuity, cataract formation, and delayed wound healing are the local adverse reactions associated with the administration of corticosteroid ophthalmic preparations like dexamethasone phosphate and are not related to the administration of trifluridine.
When assessing an infant for a possible ear infection, which of the following behaviors would the nurse note? Select all that apply.
- A. Change in behavior
- B. Nasal drainage
- C. Irritability
- D. Ear tugging
- E. Fever
Correct Answer: A,C,D,E
Rationale: When assessing the infant, the nurse would look for ear tugging, change in behavior, crying, fussing or irritability, or fever.
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.