A 45-year-old patient has been prescribed a topical antibiotic for an ear infection. What is the correct way to administer this medication?

Choice A Reason:

The statement “If I forget to take my eye drops, I should wait until the next time they are due” is incorrect. For chronic open-angle glaucoma, it is important to take eye drops as prescribed to maintain consistent intraocular pressure control. If a dose is missed, the patient should take it as soon as they remember, unless it is almost time for the next dose. Skipping doses can lead to fluctuations in eye pressure, which can worsen the condition.

Choice B Reason:

The statement “Every two years I will need to have my vision checked by an eye doctor” is not accurate. Patients with chronic open-angle glaucoma typically need more frequent monitoring, often every 3 to 6 months, depending on the severity of the condition and the stability of their intraocular pressure. Regular check-ups are crucial for adjusting treatment and preventing vision loss.

Choice C Reason:

The statement “I should call the clinic before taking any over-the-counter medications” indicates an understanding of the teaching. Some over-the-counter medications can affect intraocular pressure or interact with glaucoma medications. Consulting with a healthcare provider before taking new medications helps ensure that they do not interfere with glaucoma management.

Choice D Reason:

The statement “When my vision improves, I will be able to stop taking the eye drops” is incorrect. Glaucoma is a chronic condition that requires ongoing treatment to manage intraocular pressure and prevent further damage to the optic nerve. Stopping medication can lead to a rapid increase in eye pressure and potential vision loss.

Choice A Reason:

Administering IV levothyroxine is the priority intervention for a patient with myxedema coma. Myxedema coma is a severe form of hypothyroidism that requires immediate thyroid hormone replacement to correct the deficiency and stabilize the patient’s condition. Intravenous levothyroxine is preferred because it provides a rapid increase in thyroid hormone levels, which is crucial for reversing the life-threatening symptoms of myxedema coma, such as hypothermia, bradycardia, and altered mental status.

Choice B Reason:

Starting broad-spectrum antibiotics is not the primary intervention for myxedema coma. While infections can precipitate myxedema coma and should be treated if present, the immediate priority is to address the severe hypothyroidism with thyroid hormone replacement. Antibiotics may be administered if an infection is suspected or confirmed, but they do not directly address the underlying thyroid hormone deficiency.

Choice C Reason:

Administering corticosteroids immediately is important but not the highest priority. Corticosteroids are often given to patients with myxedema coma to treat potential adrenal insufficiency, which can coexist with severe hypothyroidism. However, the primary intervention remains the administration of thyroid hormone replacement to correct the hypothyroid state.

Choice D Reason:

Initiating fluid restriction is not appropriate for managing myxedema coma. Patients with myxedema coma often require careful fluid management to address potential hyponatremia and maintain hemodynamic stability. Fluid restriction is not a standard intervention for this condition and does not address the critical need for thyroid hormone replacement.