Nokea
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.
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The nurse is reviewing the use of ophthalmic preparations. Indications for the direct- and indirect-acting miotics include which condition?
- A. Cataracts
- B. Removal of foreign bodies
- C. Open-angle glaucoma
- D. Ocular infections
Correct Answer: C
Rationale: Indications for the direct- and indirect-acting miotics include open-angle glaucoma, angle-closure glaucoma, ocular surgery, and convergent strabismus.
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 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.
A patient with an eye injury requires an ocular examination to detect the presence of a foreign body. The nurse anticipates that which drug will be used for this examination?
- A. Phenylephrine
- B. Fluorescein sodium
- C. Atropine sulfate
- D. Olopatadine
Correct Answer: B
Rationale: Fluorescein sodium is an ophthalmic diagnostic dye used to identify corneal defects and to locate foreign objects in the eye. Phenylephrine is an ocular decongestant; atropine sulfate has mydriatic and cycloplegic effects, which are useful for examining the inner eye structures; olopatadine is an ophthalmic antihistamine.
The nurse is administering antibiotic eyedrops to a patient for the first time. After the first drop is given, the patient states, 'That eyedrop is making my eye sting! Is that normal?' Which is the best response by the nurse?
- A. That is unusual. Let me rinse the medication from your eye.
- B. Sometimes these eyedrops may cause burning and stinging, but it should go away soon.
- C. These may be serious side effects, so I will notify your doctor before the next dose is due.
- D. Let's wait and see if these effects happen the next time you receive these drops.
Correct Answer: B
Rationale: Ocular antibiotics may cause local inflammation, burning, stinging, urticaria, and dermatitis. These effects are transient. The other options are incorrect.