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: Offering mouthwash may irritate painful candidiasis ulcers in AIDS, as alcohol-based solutions exacerbate discomfort. While cleansing is important, a soft-bristled toothbrush is gentler, effectively cleaning without worsening mucosal damage, making this choice less appropriate for oral care.

Choice B reason: Providing a soft-bristled toothbrush is correct, as it gently cleans the mouth without irritating painful candidiasis ulcers in AIDS. Soft bristles minimize trauma to inflamed mucosa, promoting hygiene and comfort, making this the best instruction for safe and effective oral care by the UAP.

Choice C reason: Leaving oral care to the nurse is unnecessary, as UAPs can perform oral hygiene with proper instruction. Delegating soft-bristled toothbrush use ensures safe care for candidiasis, and reserving this task for nurses limits efficiency without clinical justification, making this choice incorrect.

Choice D reason: Wearing sterile gloves is excessive, as candidiasis is opportunistic, not requiring sterile technique. Standard precautions with clean gloves suffice for oral care in AIDS, as sterile gloves are reserved for invasive procedures, making this instruction inappropriate for routine mucosal cleansing.