The nurse administers ophthalmic timolol to a client with glaucoma. The client routinely takes carvedilol, spironolactone, and ibuprofen daily. Which medication(s) should the nurse withhold? Select all that apply.

Any antianxiety medications.

Over-the-counter oral antipyretics.

Nonsteroidal antiinflammatory drugs.

Other beta-adrenergic blocker agents.

Oral and subcutaneous anticoagulants.

Answer and Explanation

Correct Answer : C,D

Rationale:
A. Any antianxiety medications: Antianxiety medications are not contraindicated with ophthalmic timolol. Unless they directly impact heart rate or blood pressure significantly, they are generally safe to continue in clients with glaucoma using topical beta blockers.

B. Over-the-counter oral antipyretics: Oral antipyretics like acetaminophen are not known to interact adversely with timolol. These medications can be used safely unless otherwise contraindicated for specific patient conditions like liver disease.

C. Nonsteroidal antiinflammatory drugs: NSAIDs such as ibuprofen, when used long-term with beta blockers like timolol or carvedilol, may blunt the antihypertensive effect and increase renal risk, especially in clients on diuretics like spironolactone. This triple combination increases the chance of nephrotoxicity.

D. Other beta-adrenergic blocker agents: Using timolol with systemic beta blockers like carvedilol increases the risk of bradycardia, hypotension, and heart block. Though timolol is topical, systemic absorption can still occur, requiring caution when combining with other beta-blockers.

E. Oral and subcutaneous anticoagulants: There is no direct contraindication between timolol and anticoagulants. Unless the client has bleeding risks associated with other therapies or conditions, concurrent use is generally acceptable.

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Correct Answer is A

Explanation

Rationale:

A. Bacterial meningitis: This condition is highly contagious and transmitted via respiratory droplets. A private room with droplet precautions is required to prevent the spread of infection to others.

B. Septic shock: Although serious, it is not typically contagious. The client needs intensive monitoring, but isolation is not necessary unless another transmissible condition is present.

C. Brain abscess: A brain abscess is not communicable and does not require isolation. It results from localized infection and can be managed safely in a shared room with appropriate care.

D. Viral encephalitis: Viral encephalitis is usually not spread person to person in a hospital setting. Standard precautions are generally sufficient unless another communicable disease is involved.

A. Avoid using cosmetics that block sebaceous glands. B. Wear water shoes in the public shower. C. Do not share a brush or comb with anyone. D. Use moisturizing creams to retain skin moisture.

Correct Answer is B

Explanation

Rationale:

A. Avoid using cosmetics that block sebaceous glands: This advice is more relevant to preventing acne rather than tinea pedis. Tinea pedis, or athlete's foot, is caused by a fungal infection, not by clogged sebaceous glands.

B. Wear water shoes in the public shower: Tinea pedis is commonly transmitted in moist, communal environments like showers and locker rooms. Wearing protective footwear minimizes contact with contaminated surfaces, helping prevent infection.

C. Do not share a brush or comb with anyone: This applies to the prevention of tinea capitis (fungal scalp infection), not tinea pedis. Hair grooming items are not typically involved in the transmission of athlete’s foot.

D. Use moisturizing creams to retain skin moisture: Fungi thrive in warm, moist environments. Applying moisturizers excessively, especially between the toes, can promote fungal growth rather than prevent it. Dry, clean feet are key to prevention.

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The nurse administers ophthalmic timolol to a client with glaucoma. The client routinely takes carvedilol, spironolactone, and ibuprofen daily. Which medication(s) should the nurse withhold? Select all that apply.

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