A nurse is teaching a client who has glaucoma and is to start taking timolol. Which of the following information should the nurse include?
Notify the provider if you experience a stinging sensation following administration.
Watch for a decreased heart rate while using this medication.
You can expect to develop a harmless darkening of the iris.
This medication can cause the lashes of the affected eye to lengthen.
The Correct Answer is B
Choice A Reason:
Notifying the provider if you experience a stinging sensation following administration is not necessary. A mild stinging sensation is a common side effect of timolol eye drops and usually subsides quickly. However, if the stinging persists or is severe, it should be reported.
Choice B Reason:
Watching for a decreased heart rate while using this medication is important. Timolol is a beta-blocker, and one of its systemic side effects can be bradycardia (a slower than normal heart rate). Patients should be aware of this potential side effect and monitor their heart rate regularly.
Choice C Reason:
Developing a harmless darkening of the iris is not associated with timolol. This side effect is more commonly linked to prostaglandin analogs, another class of medications used to treat glaucoma.
Choice D Reason:
Timolol does not cause the lashes of the affected eye to lengthen. This side effect is also associated with prostaglandin analogs, not beta-blockers like timolol.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason
Place several pillows behind the client’s head. This intervention is incorrect. Placing several pillows behind the client’s head can lead to neck flexion, which can increase intracranial pressure by obstructing venous outflow from the brain.
Choice B Reason
Place the client in a lateral semi-prone recumbent position. This position is not ideal for managing increased intracranial pressure. The optimal position is to keep the head of the bed elevated at 30 degrees with the neck in a neutral position to promote venous drainage and reduce ICP.
Choice C Reason
Keep the client’s neck in a midline position. This is the correct intervention. Keeping the neck in a midline position helps to ensure proper venous drainage from the brain, thereby reducing intracranial pressure. It is a standard practice in managing patients with elevated ICP.
Choice D Reason
Maintain flexion of the client’s hips at a 90-degree angle. This intervention is incorrect. Flexion of the hips can increase intra-abdominal pressure, which in turn can increase intracranial pressure. It is important to avoid hip flexion in patients with elevated ICP.
Correct Answer is C
Explanation
Choice A Reason:
Remaining 1 meter (3 feet) away from the client when providing care is not sufficient to prevent the spread of tuberculosis (TB). TB is an airborne disease, and the bacteria can remain suspended in the air for several hours. Therefore, maintaining a distance alone does not provide adequate protection against inhaling the bacteria.
Choice B Reason:
Applying a surgical mask before entering the client’s room is not the most effective measure. Surgical masks are designed to protect against large droplets and splashes, but they do not provide adequate protection against airborne particles like TB bacteria. Instead, healthcare workers should use N95 respirators, which are specifically designed to filter out airborne particles.
Choice C Reason:
Ensuring the door to the client’s room is closed at all times is a critical measure in preventing the spread of TB. This action helps to contain the airborne bacteria within the room, reducing the risk of transmission to others in the healthcare facility. This is part of airborne precautions, which are essential for managing patients with active TB.
Choice D Reason:
Placing a “no visitors” sign on the client’s door can help limit the number of people exposed to the TB bacteria, but it is not the most critical action. While it is important to restrict visitors, ensuring the door is closed and using appropriate personal protective equipment (PPE) are more effective measures in controlling the spread of TB.
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