A client has been prescribed eye drops for the treatment of glaucoma. The nurse is observing the client self-administer the eye drops. Which action by the client requires further teaching?
While administering the eye drops, a drop lands on the client's outer lid, so the client administers another drop.
The client cleans the eye from the inner to the outer canthus.
The client looks upward toward the ceiling and administers the eye drops in the conjunctival sac.
The client touches the conjunctival sac with the eyedropper to make sure she is in the correct location.
The Correct Answer is D
A) While administering the eye drops, a drop lands on the client's outer lid, so the client administers another drop: This action requires further teaching. If a drop lands outside the eye, the client should not administer another drop without first cleaning the area. It’s important to avoid excessive dosing and to ensure the medication is delivered properly.
B) The client cleans the eye from the inner to the outer canthus: This is the correct technique. Cleaning the eye from the inner canthus to the outer canthus helps prevent the spread of debris and ensures a clean area for administering drops.
C) The client looks upward toward the ceiling and administers the eye drops in the conjunctival sac: This action is appropriate. Looking upward helps expose the conjunctival sac, making it easier to administer the drops effectively.
D) The client touches the conjunctival sac with the eyedropper to make sure she is in the correct location: This action requires further teaching. Touching the conjunctival sac with the eyedropper can introduce bacteria and lead to contamination or injury. The client should be advised to keep the dropper tip away from the eye to maintain sterility and safety.
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Correct Answer is C
Explanation
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B) A client who needs discharge teaching about an antibiotic: Although discharge teaching is important, it is not an immediate priority compared to the potential instability of a client with chest pain.
C) A client who just received nitroglycerin for chest pain: This is the correct choice. A client who has received nitroglycerin needs to be closely monitored for its effects, including blood pressure and relief of chest pain. This situation is potentially critical, making it the highest priority for assessment.
D) A client who would like some acetaminophen (Tylenol) for a mild headache: While this request should be addressed, it is not as urgent as the need to assess the client who has recently received nitroglycerin. Managing a mild headache is less critical compared to monitoring a client with chest pain.
Correct Answer is C
Explanation
A) Application of a transdermal patch: The application of transdermal patches is typically within the scope of licensed nursing personnel due to the need for appropriate placement, potential absorption risks, and proper documentation. This task requires understanding of the medication's effects, which is outside the scope of a UAP’s duties.
B) Use of MDIs: Metered-dose inhalers (MDIs) involve medication administration, which requires client assessment, monitoring of technique, and evaluation of response to therapy. These are skills that a UAP is not trained to handle, as they fall within a licensed nurse's responsibilities.
C) Application of a skin barrier cream to the perineal area: UAPs can apply non-medicated skin barrier creams to protect the skin in the perineal area, as it is a basic care activity. This task does not require specialized training in medication administration and is within the typical role of a UAP for maintaining skin integrity.
D) Instillation of eye drops: Administering eye drops involves medication administration, which includes proper technique, dosing, and monitoring for side effects, making it a task for licensed nursing personnel rather than a UAP.
E) Inserting rectal medications: Rectal medication insertion is a more advanced procedure that requires medication administration knowledge, correct positioning, and monitoring, which are responsibilities designated for licensed nursing staff, not a UAP.
F) Instillation of ear drops: Administering ear drops requires an understanding of dosing, technique, and monitoring for adverse effects, all of which are beyond the scope of practice for UAPs and are typically carried out by licensed nursing staff.
G) Inserting vaginal medications: Vaginal medication administration requires understanding of proper technique and monitoring for therapeutic effects or side effects, which necessitates a licensed nurse’s assessment skills and should not be delegated to a UAP.