A nurse is preparing to assist with an ocular irrigation for a client who had a chemical splash to the left eye. Which of the following actions should the nurse plan to take?
Irrigate the affected eye from the inner corner toward the outer corner.
Sit the client up with their head turned toward the right side.
Place a strip of pH paper under the upper lid of the affected eye.
Irrigate the affected eye using sterile water.
The Correct Answer is C
Choice A reason: Irrigating the affected eye from the inner corner toward the outer corner is the recommended method for ocular irrigation. This technique helps to flush out the chemical agent without risking further contamination to the other eye or nasal passages.
Choice B reason: Positioning the client sitting up with their head turned toward the right side is appropriate when irrigating the left eye. This position allows gravity to assist in the flow of the irrigation solution away from the unaffected eye, reducing the risk of cross-contamination.
Choice C reason: Placing a strip of pH paper under the upper lid of the affected eye is a critical step in ocular irrigation after a chemical splash. It is used to measure the pH of the ocular surface to ensure that the pH has normalized to a range between 7.0 and 7.2 after irrigation, indicating that the chemical has been adequately flushed out.
Choice D reason: Using sterile water for ocular irrigation is not recommended because it can cause osmotic imbalances and damage to the corneal cells. Instead, normal saline or balanced salt solutions are preferred as they are isotonic and more compatible with the physiological environment of the eye.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This statement does not indicate a need for further instruction. It is recommended to take other medications at least 30 minutes after alendronate to ensure proper absorption of the drug.
Choice B reason: This statement indicates a need for further instruction. Alendronate should be taken with plain water, not milk. The calcium in milk can interfere with the absorption of alendronate.
Choice C reason: This statement is correct and does not indicate a need for further instruction. Patients are advised to stay upright for at least 30 minutes after taking alendronate to prevent esophageal irritation or reflux.
Choice D reason: This statement is correct and does not indicate a need for further instruction. Periodic bone density tests are necessary to monitor the effectiveness of alendronate therapy in treating osteoporosis.
Correct Answer is ["8.3"]
Explanation
Step 1: Total volume = 1000 mL (which is 1 liter)
Step 2: Total time = 2 hours. But since the infusion pump rate is typically set in mL per minute, we need to convert this to minutes. There are 60 minutes in an hour, so 2 hours is 2 × 60 = 120 minutes.
Step 3: Now we can calculate the rate. The rate is the total volume divided by the total time. So, the rate = 1000 mL ÷ 120 minutes.
Calculating the above gives us the rate at which the nurse will set the infusion pump. Let's calculate it:
Step 4: Rate = 1000 mL ÷ 120 minutes = 8.33 mL/minute.
So, the nurse will set the infusion pump at a rate of approximately 8.33 mL per minute. If rounding is required, this can be rounded to 8.3 mL per minute.
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