Nokea
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.
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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.
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 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.
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 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.