A nurse is teaching a class about sleep disorders. The nurse should include that which of the following conditions can cause obstructive sleep apnea (OSA)

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.

A) The client reports dizziness when ambulating to the bathroom:
Dizziness upon ambulation is a key indicator that the client may be experiencing orthostatic hypotension, a potential side effect of antihypertensive medications. If the client is already experiencing dizziness, this could be exacerbated by administering the medication, which may cause a further drop in blood pressure. It is crucial for the nurse to further assess the client’s blood pressure (particularly orthostatic blood pressure readings) and overall clinical status before administering the medication to prevent potential falls, injury, or worsening hypotension.

B) The client reports having trouble sleeping the previous night:
While difficulty sleeping could be a concern, it is not directly related to the administration of an antihypertensive medication unless the client reports other symptoms, such as palpitations, chest pain, or anxiety, which may indicate an underlying issue. It is not a priority to delay or further assess medication administration based solely on sleep disturbances unless other significant factors are present.

C) The client ate 60% of their breakfast:
Eating 60% of the meal is not typically a reason to withhold or delay antihypertensive medication unless the client is showing signs of severe nausea, vomiting, or gastrointestinal distress. Many antihypertensive medications can be taken with food to reduce gastric irritation, and this percentage of food intake does not pose an immediate concern.

D) The client has a urine output of 400 mL for the past 8 hours:
Urine output of 400 mL over 8 hours is within the normal range (approximately 50–60 mL/hr), suggesting adequate renal function and fluid balance. While a decrease in urine output can be concerning, there is no immediate indication that this level of output would interfere with the administration of an antihypertensive medication.