A patient presents to the emergency room with symptoms of severe eye pain, blurred vision, and nausea. The ophthalmologist diagnoses the patient with acute narrow-angle glaucoma. Which of the following interventions should be prioritized to alleviate the patient’s symptoms and prevent further complications?
Administer intravenous acetazolamide to reduce intraocular pressure.
Apply warm compresses to the affected eye to relieve pain.
Encourage the patient to drink plenty of fluids to stay hydrated.
Administer a mydriatic agent to dilate the pupil.
Advising the patient to limit fluid intake to prevent kidney damage is not appropriate. In fact, adequate hydration is crucial for patients with multiple myeloma to help flush out toxins and prevent kidney damage. Limiting fluid intake can lead to dehydration and worsen kidney function, which is already at risk due to the disease.
The Correct Answer is A
Choice A Reason:
Administering intravenous acetazolamide is a critical intervention for acute narrow-angle glaucoma. Acetazolamide is a carbonic anhydrase inhibitor that reduces the production of aqueous humor, thereby lowering intraocular pressure (IOP) quickly. Reducing IOP is essential to prevent optic nerve damage and preserve vision. Normal IOP ranges from 10 to 21 mmHg, and in acute narrow-angle glaucoma, it can exceed 30 mmHg. Rapid reduction of IOP is crucial to alleviate symptoms and prevent further complications.
Choice B Reason:
Applying warm compresses to the affected eye is not an appropriate intervention for acute narrow-angle glaucoma. Warm compresses may provide temporary relief for some eye conditions, but they do not address the underlying issue of elevated intraocular pressure. In fact, warm compresses can potentially increase blood flow to the eye, which might exacerbate the condition.
Choice C Reason:
Encouraging the patient to drink plenty of fluids to stay hydrated is generally good advice for overall health, but it is not a prioritized intervention for acute narrow-angle glaucoma. Hydration does not directly impact intraocular pressure or alleviate the acute symptoms of glaucoma. The primary focus should be on reducing IOP to prevent optic nerve damage.
Choice D Reason:
Administering a mydriatic agent to dilate the pupil is contraindicated in acute narrow-angle glaucoma. Mydriatic agents can worsen the condition by further narrowing the anterior chamber angle, increasing intraocular pressure, and potentially causing more damage to the optic nerve. It is crucial to avoid pupil dilation in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Administering intravenous fluids is not the most appropriate initial action for managing hypopituitarism. While IV fluids may be necessary in cases of acute adrenal crisis or severe dehydration, they do not address the underlying hormone deficiencies caused by hypopituitarism. The primary treatment focuses on replacing the deficient hormones to restore normal physiological functions.
Choice B Reason:
Performing a transsphenoidal hypophysectomy is a surgical procedure used to remove pituitary tumors. While this may be necessary if a tumor is causing hypopituitarism, it is not the initial action for managing the condition. The first step is to stabilize the patient with hormone replacement therapy before considering surgical interventions.
Choice C Reason:
Initiating hormone replacement therapy is the most appropriate initial action for managing hypopituitarism. This condition results in the deficiency of one or more pituitary hormones, and replacing these hormones is crucial to restore normal body functions. Hormone replacement therapy may include cortisol, thyroid hormone, sex hormones, and growth hormone, depending on which hormones are deficient.
Choice D Reason:
Recommending dietary modifications alone is not sufficient to manage hypopituitarism. While a balanced diet can support overall health, it does not address the specific hormone deficiencies associated with this condition. Hormone replacement therapy is essential for managing hypopituitarism effectively.
Correct Answer is B
Explanation
Choice A Reason:
Caffeine-rich beverages are not recommended for patients with Meniere’s disease. Caffeine can exacerbate symptoms such as vertigo and tinnitus by increasing the fluid pressure in the inner ear. Therefore, avoiding caffeine is generally advised to help manage the condition.
Choice B Reason:
A low-sodium diet is an appropriate treatment for Meniere’s disease. Reducing sodium intake helps decrease fluid retention in the body, including the inner ear, which can alleviate symptoms such as vertigo, tinnitus, and hearing loss. This dietary modification is a cornerstone of managing Meniere’s disease and can significantly improve the patient’s quality of life.
Choice C Reason:
High-intensity interval training (HIIT) is not suitable for patients with Meniere’s disease. Intense physical activity can trigger vertigo attacks and worsen balance issues. Patients are generally advised to engage in moderate, low-impact exercises that do not provoke symptoms.
Choice D Reason:
Prolonged bed rest is not an appropriate treatment for Meniere’s disease. While rest may be necessary during acute vertigo attacks, long-term bed rest can lead to deconditioning and other health issues. It is important for patients to maintain a balance between rest and activity to manage their symptoms effectively.
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