Nokea
Before administering an otic preparation, which of the following would the nurse be responsible for during the preadministration assessment? Select all that apply.
- A. Documentation of a description of any drainage
- B. Examination of the outer structures of the earlobe
- C. Examination of the inner structures of the ear
- D. Documentation of a description of visible cerumen
- E. Examination of the skin around the ear
Correct Answer: A,B,D,E
Rationale: During preadministration assessment before administering an otic preparation, the nurse is responsible for the following: examination of the outer structures of the ear (earlobe and the skin around the ear) and documentation of a description of any drainage or visible cerumen. The primary health care provider examines the ear's external and internal structures.
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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.
After teaching a group of nursing students about otic preparations, the instructor determines that the teaching was successful when the students match which ingredient to its correct action? Select all that apply.
- A. Antipyrine decongestant
- B. Benzocaine - local anesthetic
- C. Hydrocortisone - corticosteroid
- D. Carbamide peroxide - antimicrobial
- E. Acetic acid - antimicrobial
Correct Answer: B,C,E
Rationale: The following ingredients found in miscellaneous otic preparations are correctly matched with their action: benzocaine - local anesthetic, hydrocortisone corticosteroid, and acetic acid - antimicrobial. Antipyrine is an analgesic; carbamide peroxide aids in removing cerumen.
The nurse should discuss which of the following adverse reactions with a client prior to the administration of dexamethasone (Maxidex)? Select all that apply.
- A. Increased intraocular pressure
- B. Headache
- C. Numbness
- D. Ptosis
- E. Cataract formation
Correct Answer: A,D,E
Rationale: The nurse should discuss the following adverse reactions with a client prior to the administration of an ophthalmic corticosteroid, like dexamethasone (Maxidex): increased intraocular pressure with optic nerve damage, loss of visual acuity, cataract formation, delayed wound healing, secondary ocular infection, exacerbation or corneal infections, dry eyes, ptosis, blurred vision, discharge, ocular pain, foreign body sensation, and pruritus.
After teaching a group of nursing students about otic preparations, the instructor determines that the teaching was successful when the group identifies which of the following preparations as being used to aid in the removal of cerumen? Select all that apply.
- A. Cipro HC otic
- B. Floxin otic
- C. Debrox
- D. Acetasol HC
- E. Cerumenex
Correct Answer: C,E
Rationale: Carbamide peroxide (Debrox) and triethanolamine polypeptide (Cerumenex) are otic preparations used to aid in the removal of cerumen.
A patient with open-angle (chroniglaucoma has been prescribed brimonidine tartrate to lower intraocular pressure (IOP). After administering the drug, the nurse should monitor which of the following in the patient as a local effect of brimonidine tartrate?
- A. Allergic lip reactions
- B. Foreign body sensation
- C. Deposits in the cornea
- D. Brow ache and headache
Correct Answer: B
Rationale: Although side effects are usually mild, treatment with brimonidine tartrate includes local effects like foreign body sensation, ocular hyperemia, burning and stinging, headache, visual blurring, ocular allergic reactions, and ocular pruritus. Allergic lip reactions, deposits in the cornea, brow ache, and headache are the transient local reactions to sympathomimetic drugs.