Nokea
The ophthalmic preparation erythromycin (Ilotycin) is contraindicated in clients with which of the following? Select all that apply.
- A. Gonorrheal infection of the eye
- B. Varicella infection of the eye
- C. Fungal infection of the eye
- D. Epithelial herpes simplex keratitis of the eye
- E. Mycobacterial infection of the eye
Correct Answer: B,C,D,E
Rationale: Antibiotic ophthalmic preparations, like erythromycin (Ilotycin), are contraindicated in clients with the following: epithelial herpes simplex keratitis, varicella, mycobacterial, and fungal infections of the eye.
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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 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.
The nurse should discuss which of the following adverse reactions with a client prior to the administration of a drug to treat glaucoma? Select all that apply.
- A. Ocular burning
- B. Headache
- C. Numbness
- D. Tearing
- E. Blurred vision
Correct Answer: A,B,D,E
Rationale: The nurse should discuss the following adverse reactions with a client prior to the administration of drugs used to treat glaucoma: locally in or near the eye-burning and stinging, headache, blurred vision, tearing, foreign body sensation, ocular allergic reactions, and ocular itching.
The nurse should question a client complaining of ear pain about which of the following during the assessment? Select all that apply.
- A. Tinnitus
- B. Feeling of fullness in the ear
- C. Dizziness
- D. Drowsiness
- E. Change in hearing
Correct Answer: A,B,C,E
Rationale: The nurse should question a client complaining of ear pain about the following: presence of tinnitus or dizziness, changes in hearing, and feeling of fullness in the ear.
A client receiving ophthalmic drugs reports blurred vision. He tells the nurse, 'I almost fell yesterday.' The nurse identifies which nursing diagnosis?
- A. Risk for Infection
- B. Risk for Injury
- C. Acute Pain
- D. Anxiety
Correct Answer: B
Rationale: The client's complaint of blurred vision and his report of almost falling support the nursing diagnosis of Risk for Injury. Risk for Infection would be appropriate if the client had an infection or did not correctly instill the eyedrops, contaminating the container and/or solution. Acute Pain would be more appropriate if the client complained of pain either from the disorder or as an adverse effect. Although the client may be anxious, there is no evidence to support it.