A client with open-angle glaucoma is using pilocarpine opthalmic solution, a miotic agent. Which action should the nurse at the eye clinic include in evaluating the effectiveness of the medication?

A. Palpate eyelids for decreased swelling: Pilocarpine is used to lower intraocular pressure in glaucoma by promoting aqueous humor drainage; it does not primarily target eyelid swelling. Palpating the eyelids would not provide relevant information about the drug’s effectiveness.

B. Check amount of drainage from each eye: Drainage from the eyes may suggest infection or irritation but is not a measure of how well pilocarpine is controlling intraocular pressure. Monitoring drainage does not directly assess the therapeutic effect of a miotic agent.

C. Review eye pressure measurements: The primary goal of pilocarpine therapy in open-angle glaucoma is to lower intraocular pressure (IOP) to prevent optic nerve damage and preserve vision. Evaluating IOP measurements directly assesses the effectiveness of the medication in achieving its intended outcome.

D. Use Snellen chart to assess visual acuity: While maintaining vision is a long-term goal in glaucoma management, changes in visual acuity do not immediately reflect the effectiveness of pilocarpine. Vision loss occurs over time if IOP is not controlled, making pressure monitoring a more immediate and sensitive indicator.

A. Absence of xerostomia: Bethanechol, a cholinergic agonist, can stimulate salivary secretions and reduce dry mouth (xerostomia), but its primary therapeutic use in urinary retention focuses on improving bladder emptying rather than treating oral dryness. Thus, this is not the best indicator of its effectiveness for urinary issues.

B. Denies stress incontinence: Stress incontinence is unrelated to the mechanism of bethanechol, which promotes bladder contraction to facilitate complete emptying. Denying stress incontinence does not necessarily confirm that urinary retention has been resolved.

C. Urinary output equals intake: Bethanechol stimulates the detrusor muscle of the bladder, enhancing its contraction and promoting urination. When urinary output matches intake, it indicates that the bladder is emptying properly, reflecting the medication’s intended therapeutic effect in managing urinary retention.

D. No terminal urinary dribbling: Absence of dribbling may suggest better bladder control, but it does not directly confirm the resolution of urinary retention. Complete and regular bladder emptying, indicated by output equaling intake, is a more accurate measure of effective treatment.