A nurse is preparing to administer Timolol eye drops to a patient with glaucoma. Which of the following actions should the nurse prioritize when administering this medication?
Apply the drops directly onto the patient's cornea
Perform punctal occlusion after instilling the drops
Administer the medication immediately after meals
Instruct the patient to blink rapidly after instillation
The Correct Answer is B
A. Apply the drops directly onto the patient's cornea: Eye drops should be instilled into the conjunctival sac, not directly onto the cornea. The cornea is highly sensitive, and direct application can cause discomfort, injury, and decreased patient adherence.
B. Perform punctal occlusion after instilling the drops: Punctal occlusion (gentle pressure on the inner corner of the eye) for 1–2 minutes reduces systemic absorption of the drug via the nasolacrimal duct. This is especially important with beta-blockers like Timolol, which can cause systemic effects such as bradycardia and hypotension.
C. Administer the medication immediately after meals: The timing of Timolol eye drops is not dependent on meals. Food intake has no impact on the efficacy or absorption of ophthalmic medications.
D. Instruct the patient to blink rapidly after instillation: Blinking rapidly can cause the medication to be expelled from the eye, reducing its effectiveness. Patients should be instructed to gently close the eye for a minute or two to enhance absorption.
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Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"}}
Explanation
- Losartan: As an angiotensin II receptor blocker (ARB), losartan reduces aldosterone secretion, leading to decreased potassium excretion and potential hyperkalemia, especially in patients with renal impairment or those on potassium supplements.
- Furosemide: This loop diuretic promotes the excretion of sodium and potassium in the urine, commonly resulting in hypokalemia. Patients on furosemide often require potassium monitoring or supplementation.
- Spironolactone: A potassium-sparing diuretic and aldosterone antagonist, spironolactone reduces potassium excretion in the distal nephron. This can lead to hyperkalemia, particularly when used with other potassium-elevating drugs.
- Lisinopril: An ACE inhibitor that blocks the conversion of angiotensin I to II, reducing aldosterone levels and thereby decreasing potassium excretion. This places patients at risk for hyperkalemia.
- Digoxin: This cardiac glycoside may cause hypokalemia indirectly by increasing sensitivity to potassium shifts. Additionally, low potassium levels enhance digoxin toxicity, so maintaining normal potassium is critical during therapy.
Correct Answer is B
Explanation
A. Intramuscular Phenobarbital: While effective as an anticonvulsant, phenobarbital has a slower onset of action and is not the preferred first-line treatment for acute seizures. It is more commonly used in refractory cases or for long-term seizure control.
B. Intravenous Lorazepam: Lorazepam is a benzodiazepine and the first-line treatment for active seizures, especially status epilepticus. Given IV, it acts quickly by enhancing GABA activity, which calms neuronal excitability and stops seizure activity efficiently.
C. Oral Phenytoin: Phenytoin is used for long-term seizure prevention but is not effective for terminating ongoing seizures due to its slow onset when taken orally. It may be used after benzodiazepines to prevent seizure recurrence but not as the initial agent.
D. Subcutaneous Sumatriptan: Sumatriptan is used for treating acute migraines and has no role in managing seizures. It acts on serotonin receptors to relieve migraine symptoms, not to control abnormal neuronal discharges.
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