The emergency department nurse is caring for a patient who has had a chemical splash in both eyes. What is the priority nursing action?

Instill anesthetic eye drops in both eyes

Perform a visual acuity exam

Determine the pH of the chemical splash

Irrigate both eyes with normal saline

Answer and Explanation

The Correct Answer is D

A. Anesthetic eye drops can help with pain, but irrigation is the priority to prevent further damage.

B. A visual acuity exam is part of the assessment but should be performed after initial irrigation to prevent further damage.

C. Determining the pH of the chemical splash can guide further treatment but is secondary to immediate irrigation to dilute and remove the chemical.

D. Irrigating both eyes with normal saline is the priority action to dilute and flush out the chemical, reducing the risk of further injury.

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Correct Answer is B

Explanation

A. A hearing test does not address the infection symptoms and would not be the priority.

B. Obtaining a culture of the drainage is necessary to identify any infection and guide appropriate antibiotic treatment.

C. Removing a foreign body may not be relevant and could worsen infection symptoms if not necessary.

D. A CT scan may be needed if further complications are suspected, but it is not the priority for infection symptoms.

A. Use the head tilt chin lift method to maintain the airway B. Control any external bleeding C. Do not move the victim from the accident D. Stabilize the cervical spine until help arrives

Correct Answer is D

Explanation

A. The head tilt chin lift method should be avoided due to the risk of aggravating a spinal injury; the jaw-thrust maneuver is safer if airway management is necessary.

B. While controlling bleeding is important, cervical spine stabilization takes priority in trauma with suspected spinal injury.

C. Not moving the victim is appropriate, but stabilizing the cervical spine provides active support to avoid further injury.

D. Stabilizing the cervical spine is crucial to prevent potential spinal cord damage in an unconscious trauma victim, particularly in a motor vehicle accident. This action helps prevent exacerbation of any spinal injury.

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The emergency department nurse is caring for a patient who has had a chemical splash in both eyes. What is the priority nursing action?

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The nurse is assessing a patient with a cochlear implant and notices that there is drainage, swelling, and tenderness behind the ear with the implant. What is the priority nursing intervention?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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