Nokea
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.
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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.
A patient has been using dexamethasone eyedrops for allergic conjunctivitis but has developed bacterial conjunctivitis and has a prescription for gentamicin (Garamycin) ointment. The nurse notes that which interaction is possible if the two drugs are used together?
- A. The infection may become systemic.
- B. The gentamicin effects may become more potent.
- C. The corticosteroid may cause overgrowth of nonsusceptible organisms.
- D. Immunosuppression may make it more difficult to eliminate the eye infection.
Correct Answer: D
Rationale: Concurrent use of corticosteroids, such as dexamethasone, and ophthalmic antimicrobials may cause immunosuppression that may make it more difficult to eliminate the eye infection.
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.
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.
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.