An older adult female client is hospitalized with a fractured femur. During a routine nursing assessment, she repeatedly asks the nurse to “speak up” so that she can hear the questions. Which action is best for the nurse to take?

Choice A reason: Temporary use until pressure stabilizes is incorrect, as open-angle glaucoma is a chronic condition requiring ongoing intraocular pressure control. Eye drops, like beta-blockers, reduce aqueous humor production, but stopping them risks pressure spikes, leading to optic nerve damage and vision loss.

Choice B reason: Lifelong eye drop use is accurate, as open-angle glaucoma is a progressive disease where optic nerve damage is prevented by maintaining low intraocular pressure. Drops like prostaglandins increase aqueous outflow, requiring continuous use to prevent irreversible vision loss, making this the correct response.

Choice C reason: Using drops only during symptomatic episodes is incorrect, as glaucoma is often asymptomatic until advanced. Consistent eye drop use prevents pressure buildup, protecting the optic nerve. Symptomatic treatment fails to address chronic pressure elevation, risking progressive vision loss.

Choice D reason: Discontinuing drops once vision improves is incorrect, as vision improvement is not expected in glaucoma. Eye drops maintain intraocular pressure to slow disease progression, not reverse damage. Stopping treatment allows pressure to rise, accelerating optic nerve damage and vision loss.

Choice A reason: Monitoring urine output assesses fluid status but does not directly prevent hypernatremia, which results from excess sodium or water loss. Reducing dietary sodium intake is more proactive, as urine output is a secondary indicator, making this instruction less effective for management.

Choice B reason: Using salt tablets after exercise is dangerous, as they increase sodium intake, worsening hypernatremia. This condition requires sodium reduction and water replacement, making this instruction harmful, as it exacerbates elevated serum sodium levels, risking neurological complications.

Choice C reason: Reviewing food labels for sodium content is critical, as hypernatremia results from high sodium intake or water loss. Limiting dietary sodium prevents further elevation of serum sodium, protecting against cerebral edema or seizures, making this the most effective discharge instruction.

Choice D reason: Drinking water when thirsty helps hydration but is reactive and insufficient for hypernatremia, which requires proactive sodium reduction. Thirst may be impaired in some patients, and dietary sodium control is more direct, making this instruction less comprehensive than label review.