Nokea
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.
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When teaching a patient about the proper application of eyedrops, the nurse will include which instruction?
- A. Apply the drops into the conjunctival sac instead of directly onto the eye.
- B. Apply the drops directly to the eyeball (cornea) for the best effect.
- C. Blot your eye with a tissue immediately after applying the drops.
- D. Tilt your head forward before applying the eyedrops.
Correct Answer: A
Rationale: All ophthalmic drugs should be administered in the conjunctival sac. Gently use a tissue to remove excess eye medication"do not blot the eye after giving the medication. Tilt the head back before giving the eyedrops.
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 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 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 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.