Nokea
A patient is about to undergo ocular surgery. The preoperative nurse anticipates that which drug will be used for local anesthesia?
- A. Oral glycerin
- B. Proparacaine eye drops
- C. Timolol eye drops
- D. Dipivefrin eye drops
Correct Answer: B
Rationale: Proparacaine and tetracaine are used as a local anesthetic for ocular surgery or other procedures. The other drugs are used for glaucoma.
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A patient has a new prescription for an antiglaucoma eyedrop. The next day, she calls the clinic and states, 'The package insert says this medication might make my blue eyes turn brown! Is this true?' The nurse realizes that the patient has a prescription for which eye medication?
- A. Latanoprost, a prostaglandin agonist
- B. Dorzolamide, an ocular carbonic anhydrase inhibitor
- C. Betaxolol, a direct-acting beta blocker
- D. Pilocarpine, a direct-acting cholinergic
Correct Answer: A
Rationale: There is one unique adverse effect associated with all prostaglandin agonists"in some people with hazel, green, or bluish-brown eye color, eye color will turn permanently brown, even if the medication is discontinued. This adverse effect appears to be cosmetic only, with no known ill effects on the eye. The other medications do not have this effect.
The nurse will be giving ophthalmic drugs to a patient with glaucoma. Which drug is given intravenously to reduce intraocular pressure when other medications are not successful?
- A. Tobramycin
- B. Bacitracin
- C. Mannitol
- D. Ketorolac
Correct Answer: C
Rationale: Drugs used to reduce intraocular pressure include osmotic diuretics such as mannitol, which is given intravenously. Tobramycin and bacitracin are antibiotics; ketorolac has anti-inflammatory actions.
The nurse is administering ophthalmic drops. Choose the action that should be performed first.
- A. Close the eye gently.
- B. Apply gentle pressure to the inner canthus/lacrimal sac for 1 minute.
- C. Place drops into the conjunctival sac.
- D. Clean debris from the eye as needed.
- E. Have the patient tilt the head back and look up at the ceiling.
- F. Remove excess medication gently from around the eyes.
Correct Answer: D
Rationale: Before applying eye medications, clean any debris from the eye, if needed, and have the patient tilt the head back and look up at the ceiling. Drops are placed into the conjunctival sac, and then the eye is closed gently. Pressure may be applied to the inner canthus/lacrimal sac for 1 minute to reduce systemic absorption, and any excess medication can then be removed from around the eyes.
The nurse is reviewing the medical record of a patient and notes an order for ophthalmic dexamethasone (Decadron) solution. The nurse knows that indications for ophthalmic dexamethasone include which conditions? (Select all that apply.)
- A. Uveitis
- B. Allergic conditions
- C. Removal of foreign bodies
- D. Ocular infections
- E. Glaucoma
- F. Conjunctival inflammation
Correct Answer: A,B,C,F
Rationale: Dexamethasone (Decadron) is used to treat inflammation of the eye, eyelids, conjunctiva, and cornea, and it may also be used in the treatment of uveitis, iridocyclitis, allergic conditions, and burns and in the removal of foreign bodies. It is not indicated for infections or glaucoma.
A patient is receiving ocular cyclosporine and also has an order for an artificial tears product. The nurse includes which instructions in the teaching plan for these medications?
- A. These two eye drugs cannot be given together. Let's check with your prescriber.
- B. You may take these two drugs together at the same time.
- C. First take the artificial tears, and then take the cyclosporine drops after 5 minutes.
- D. Take the cyclosporine drops first, and then wait 15 minutes before taking the artificial tears.
Correct Answer: D
Rationale: Cyclosporine (Restasis) can be used together with artificial tears if the drugs are given 15 minutes apart. The other options are incorrect.