Which of the following are important points for the nurse to remember when administering an otic preparation to a client? Select all that apply.
- A. Have client tilt head downward.
- B. Warm the otic preparation prior to administration.
- C. Straighten the ear canal.
- D. Never insert the dropper tip into the ear canal.
- E. Insert a piece of cotton loosely into the ear canal to prevent the drug from flowing out.
Correct Answer: B,C,D,E
Rationale: The following are important points for the nurse to remember when administering an otic preparation to a client: have the client lie on his or her side or tilt his or her head with the infected ear facing the ceiling; warm the otic preparation prior to administration; straighten the ear canal; insert a piece of cotton loosely into the ear canal to prevent the drug from flowing out; and never insert the dropper tip into the ear canal.
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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.
A client is diagnosed with springtime allergic conjunctivitis. The nurse would expect which of the following to be prescribed? Select all that apply.
- A. Brimonidine (Alphagan)
- B. Gatifloxacin (Zymar)
- C. Betaxolol (Betoptic)
- D. Pemirolast (Alamast)
Correct Answer: D
Rationale: Mast cell stabilizers, like nedocromil (Alocril) and pemirolast (Alamast), are ophthalmic drugs useful in a client who has allergic conjunctivitis during the spring.
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.
A client is receiving multiple ophthalmic drugs. Which of the following ophthalmic preparations would the nurse administer to the client for the purpose of treating increased intraocular pressure? Select all that apply.
- A. Brimonidine (Alphagan)
- B. Apraclonidine (Iopidine)
- C. Tobramycin (TobraDex)
- D. Ofloxacin (Ocuflox)
- E. Ganciclovir (Vitrasert)
Correct Answer: A,B
Rationale: Brimonidine (Alphagan) and apraclonidine (Iopidinare ophthalmic preparations used to treat increased intraocular pressure.
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.
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