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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["100"]
Explanation
Calculating the IV Infusion Rate
Problem: Administer 300 mg of clindamycin IV over 30 minutes. The available solution is 300 mg in 50 mL of 0.9% NaCl.
Steps:
Convert minutes to hours:
30 minutes x (1 hour / 60 minutes) = 0.5 hours
Calculate the infusion rate:
50 mL / 0.5 hours = 100 mL/hour
Answer: The nurse should set the IV pump to deliver 100 mL/hour.
Correct Answer is B
Explanation
A) Withholding the medication if the heart rate is above 100/min:
Digoxin is typically withheld if the heart rate is below 60 beats per minute (bradycardia) rather than above 100 beats per minute. In fact, a heart rate above 100/min may indicate tachycardia, which is not necessarily a contraindication for administering digoxin.
B) Evaluating the client for nausea, vomiting, and anorexia:
These symptoms are signs of digoxin toxicity. Evaluating for these symptoms is crucial as part of monitoring for adverse effects. Clients experiencing these symptoms may need their digoxin levels checked and potentially adjusted.
C) Instructing the client to eat foods that are low in potassium:
Digoxin therapy requires adequate potassium levels for effectiveness. Clients should be encouraged to consume foods high in potassium to prevent hypokalemia, which can increase the risk of digoxin toxicity.
D) Measuring apical pulse rate for 30 seconds before administration:
The apical pulse should be measured for a full minute to accurately assess the heart rate before administering digoxin. A shorter measurement may not provide a reliable assessment of the heart rate.
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