A nurse in an ophthalmology clinic is assessing a client who has suspected primary open-angle glaucoma (PAOG). Which assessment finding would support a diagnosis of this type of glaucoma?

Loss of peripheral vision

Opacity of the lens

Decrease in color perception

Pain and purulent discharge

Answer and Explanation

The Correct Answer is A

A.   Loss of peripheral vision is a hallmark sign of primary open-angle glaucoma. In POAG, increased intraocular pressure causes damage to the optic nerve, leading to a gradual loss of peripheral vision. This vision loss is often subtle and progresses slowly, making it difficult for individuals to notice until the condition is advanced.

B.   Opacity of the lens is characteristic of cataracts, not glaucoma. Cataracts involve the clouding of the eye's natural lens, which leads to blurred vision and difficulties with seeing clearly, particularly in bright light. While cataracts and glaucoma can occur simultaneously, opacity of the lens is not indicative of POAG.
C.   Decrease in color perception can be associated with various eye conditions, including age-related macular degeneration (AMD) and certain types of retinal diseases. While it can occur in glaucoma as the disease progresses, it is not the primary or most characteristic sign of POAG.
D.   Pain and purulent discharge are more associated with acute conditions such as conjunctivitis (pink eye) or an eye infection, rather than primary open-angle glaucoma. POAG typically presents without pain or discharge, as it is a chronic condition with a gradual onset of symptoms.

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Correct Answer is D

Explanation

A. Pyridostigmine is primarily used in the treatment of myasthenia gravis, a different autoimmune neuromuscular disorder characterized by weakness of voluntary muscles. It works by inhibiting the

enzyme acetylcholinesterase, which increases the levels of acetylcholine at neuromuscular junctions, thereby improving muscle strength. It is not used for treating multiple sclerosis.
B. Levodopa-carbidopa is commonly used to treat Parkinson’s disease. Levodopa is converted to dopamine in the brain, and carbidopa prevents levodopa from being converted into dopamine before it reaches the brain. This combination helps manage the motor symptoms of Parkinson’s disease. It is not used for multiple sclerosis.
C. Riluzole is used primarily for the treatment of amyotrophic lateral sclerosis (ALS), a neurodegenerative disease affecting motor neurons. It works by reducing the release of glutamate, a neurotransmitter that can be toxic to nerve cells. Riluzole is not used for multiple sclerosis.
D. Interferon-beta is a disease-modifying therapy used in the treatment of multiple sclerosis. It works by modulating the immune system to reduce the frequency and severity of MS relapses. Interferon-beta can help slow the progression of disability and reduce the number of new lesions seen on MRI scans.

A. Prepare the client for cardiac catheterization B. Transport the client for a STAT echocardiogram C. Administer warfarin for anticoagulation D. Administer furosemide via slow IV push E. Place the client on supplemental oxygen F. Administer sublingual nitroglycerin G. Place the client on a clear liquid diet

Correct Answer is ["A","E","F"]

Explanation

A. Cardiac catheterization is often used in the management of an acute myocardial infarction to assess the extent of coronary artery disease and to determine the need for interventions such as angioplasty and stenting. This procedure is crucial for reperfusion therapy, especially in the context of ST-elevation MI (STEMI). Given the client’s symptoms and diagnostic findings, preparing for cardiac catheterization is an appropriate order.
B. While an echocardiogram can be useful for evaluating cardiac function and determining the extent of myocardial damage, it is not typically the immediate priority in the acute management of an MI. The focus is usually on rapid reperfusion therapy and stabilizing the patient. Therefore, this option is less urgent compared to others like administering oxygen and preparing for cardiac catheterization.
C. Warfarin is an oral anticoagulant used for long-term anticoagulation management and is not typically used in the acute setting of an MI. In acute MI management, other anticoagulants such as heparin or low molecular weight heparin are preferred for immediate anticoagulation. Administering warfarin in the acute setting is not appropriate.
D. Furosemide is a diuretic used to manage fluid overload and reduce symptoms of heart failure. It is not indicated as an immediate intervention in acute MI unless there is evidence of significant fluid overload or heart failure symptoms. The client’s current presentation does not suggest an immediate need for furosemide.
E. Supplemental oxygen is important in the management of acute myocardial infarction to ensure
adequate oxygen delivery to the myocardium and to alleviate hypoxia, especially since the client’s oxygen saturation is low at 92%. Providing supplemental oxygen is a standard intervention in the acute management of MI.
F. Sublingual nitroglycerin is commonly used to relieve chest pain in myocardial infarction by causing vasodilation. However, it should be used with caution in the presence of hypotension or other contraindications. Given the client’s symptoms and high heart rate, nitroglycerin could be appropriate,
but should be carefully monitored for effects on blood pressure.
G. A clear liquid diet is not an immediate priority in the management of acute myocardial infarction. Diet modification may be considered later in the course of treatment, but it is not a critical intervention in the acute phase.

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A nurse in an ophthalmology clinic is assessing a client who has suspected primary open-angle glaucoma (PAOG). Which assessment finding would support a diagnosis of this type of glaucoma?

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Which medication is commonly used in the treatment of multiple sclerosis?

Correct Answer is D

Explanation

A nurse in an emergency department (ED) is admitting a client. Exhibits Select the 3 orders that the nurse should expect for this client.

Correct Answer is ["A","E","F"]

Explanation

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