A nurse is preparing to administer an ophthalmic medication to a client. Which of the following actions should the nurse plan take?

Apply pressure to the client's nasolacrimal duct after instillation.

Clean the client's eye from the outer canthus to the inner canthus before instillation.

Ask the client to tightly squeeze their eyes shut after the instillation.

Instill the ophthalmic medication directly on the client's cornea.

Answer and Explanation

The Correct Answer is A

A) Apply pressure to the client's nasolacrimal duct after instillation:
Applying gentle pressure to the nasolacrimal duct (located at the inner corner of the eye) after administering ophthalmic medication helps to reduce systemic absorption and increase the medication’s efficacy. This technique helps to prevent the medication from draining into the nasolacrimal duct and into the systemic circulation.

B) Clean the client's eye from the outer canthus to the inner canthus before instillation:
The eye should be cleaned from the inner canthus to the outer canthus to avoid transferring debris or infection from the outer parts of the eye to the inner areas. Cleaning from outer to inner canthus may cause contamination.

C) Ask the client to tightly squeeze their eyes shut after the instillation:
Asking the client to tightly squeeze their eyes shut is not recommended as it can cause the medication to be expelled or lead to increased systemic absorption. Instead, the client should gently close their eyes to allow for proper absorption.

D) Instill the ophthalmic medication directly on the client's cornea:
The medication should be administered into the conjunctival sac rather than directly on the cornea. Direct application to the cornea can cause irritation or damage.

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Correct Answer is A

Explanation

A) Check the client's vital signs:
The first priority after administering the wrong medication is to assess the client's immediate condition and check for any adverse reactions or changes in vital signs. This helps determine if the medication has caused any immediate harm and guides further action to ensure the client's safety.

B) Document the client's condition in the electronic medical record:
Documenting the incident is important for legal and clinical reasons, but it should be done after addressing the immediate health concerns of the client. Ensuring the client’s safety is the top priority.

C) Notify the provider:
Notifying the healthcare provider is crucial, but it is important to first assess the client's condition. Once the client’s immediate needs are addressed, informing the provider will help in deciding further medical interventions or adjustments needed.

D) Fill out an incident report:
Filling out an incident report is a necessary step for documenting the error and contributing to quality improvement processes, but it should be done after the client’s safety has been assured and immediate medical concerns have been addressed.

A. Epinephrine B. Atropine C. Protamine D. Vitamin K

Correct Answer is D

Explanation

A) Epinephrine:
Epinephrine is used in emergency situations such as anaphylaxis or cardiac arrest. It does not reverse the effects of anticoagulants like warfarin and is not indicated for managing an elevated INR.

B) Atropine:
Atropine is used to treat bradycardia (slow heart rate) and other conditions but does not counteract the effects of warfarin. It is not appropriate for managing an elevated INR.

C) Protamine:
Protamine is used to reverse the effects of heparin, an anticoagulant, not warfarin. It is not effective in managing high INR levels associated with warfarin therapy.

D) Vitamin K:
Vitamin K is the appropriate antidote for reversing the effects of warfarin. An INR of 5.2 indicates a high risk of bleeding, and administering Vitamin K can help to reduce the anticoagulant effects of warfarin and bring the INR back to a safer range.

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A nurse is preparing to administer an ophthalmic medication to a client. Which of the following actions should the nurse plan take?

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