A nurse is preparing to administer furosemide 30 mg IV bolus stat. Available is furosemide injection 10 mg/mL. How many mL should the nurseadminister? (Round the answer to the nearest whole number. Use leading zero if it applies. Do not use a trailing zero.)

A) SOAP documentation:
SOAP (Subjective, Objective, Assessment, Plan) documentation is a method used for organizing and documenting client information. It focuses on both subjective and objective data, as well as the assessment and plan. While SOAP helps structure the documentation of patient conditions and interventions, it does not specifically focus on documenting only unexpected findings. It is a more comprehensive approach that includes normal and abnormal findings, not just the unexpected ones.

B) Focus charting (DAR):
Focus charting (DAR) is based on a client-centered approach and uses the components of Data, Action, and Response. It is a way of documenting observations and interventions, particularly in relation to specific patient problems or conditions. Focus charting is more about the care provided, responses to interventions, and client outcomes. While it may include unexpected findings, it doesn’t limit documentation exclusively to abnormal or unexpected events.

C) Charting by exception (CBE):
Charting by exception (CBE) is a documentation method that focuses on recording only the significant deviations from the norm. It emphasizes noting any abnormal or unexpected findings, and everything that is normal is assumed to be within expected limits and not documented. This method reduces the amount of documentation by excluding routine information and only highlighting significant, unexpected findings. Therefore, CBE is the correct answer in this scenario, as it involves documenting only unexpected or abnormal findings related to the client's condition.

D) Problem-oriented medical record (POMR):
POMR is a method of documentation that organizes client care around specific problems or diagnoses. It includes the identification of problems, interventions, and outcomes. While POMR focuses on client problems and plans of care, it does not specifically focus on documenting only unexpected findings. It may include both normal and abnormal findings related to each identified problem.

A) Apply pressure to the client’s nasolacrimal duct after instillation:
Applying gentle pressure to the nasolacrimal duct after administering an ophthalmic medication is a recommended practice. This action prevents the medication from draining into the nasopharynx, reducing the risk of systemic absorption and minimizing potential side effects. It also helps ensure that the medication stays localized in the eye for maximum therapeutic effect. This technique is especially important for medications like eye drops that could otherwise be absorbed systemically, such as those for glaucoma treatment.

B) Clean the client's eye from the outer canthus to the inner canthus before instillation:
The correct procedure for cleaning the eye prior to instilling ophthalmic medication is to clean from the inner canthus (near the nose) to the outer canthus (toward the temple). This technique avoids dragging debris from the outer eye toward the sensitive inner corner and helps prevent introducing contaminants into the eye. Cleaning from outer to inner canthus could potentially push debris toward the tear ducts and further irritate the eye.

C) Ask the client to tightly squeeze their eyes shut after the instillation:
Asking the client to tightly squeeze their eyes shut after instillation is not recommended. Squeezing the eyes shut can increase intraocular pressure and may actually force the medication out of the eye, reducing its effectiveness. Instead, the client should be encouraged to gently close their eyes and avoid blinking excessively. This allows the medication to stay in contact with the eye for a longer period.

D) Instill the ophthalmic medication directly on the client's cornea:
Instilling ophthalmic medication directly on the cornea is not recommended. The correct technique is to instill the medication into the conjunctival sac, which is the space between the lower eyelid and the eyeball. Instilling the medication directly onto the cornea could lead to irritation, discomfort, or damage to the sensitive corneal surface, and it would not allow the medication to be absorbed as intended.