A nurse at an ophthalmology clinic is providing teaching to a client who has open-angle glaucoma and a new treatment regimen of timolol and pilocarpine eye drops. Which of the following instructions should the nurse provide?
Administer the medications 5 minutes apart.
Hold pressure on the conjunctival sac for 2 minutes following application of drops.
It is not necessary to remove contact lenses before administering medications.
Administer the medications by touching the tip of the dropper to the sclera of the eye.
The Correct Answer is A
Choice A: Administer the Medications 5 Minutes Apart
Administering the medications 5 minutes apart is crucial when using multiple eye drops. This practice ensures that each medication has enough time to be absorbed without being washed out by the subsequent drop. This is particularly important for medications like timolol and pilocarpine, which are used to manage intraocular pressure in glaucoma.
Choice B: Hold Pressure on the Conjunctival Sac for 2 Minutes Following Application of Drops
Holding pressure on the conjunctival sac (punctal occlusion) for 2 minutes after applying eye drops can help reduce systemic absorption and increase the local effect of the medication. However, this instruction is not as critical as the timing between administering different eye drops.
Choice C: It Is Not Necessary to Remove Contact Lenses Before Administering Medications
This statement is incorrect. Contact lenses should be removed before administering eye drops to prevent contamination and ensure proper absorption of the medication. The lenses can be reinserted after a sufficient amount of time has passed, usually around 15 minutes.
Choice D: Administer the Medications by Touching the Tip of the Dropper to the Sclera of the Eye
This statement is incorrect. The tip of the dropper should never touch the eye or any other surface to avoid contamination. The correct method is to hold the dropper above the eye and squeeze out the prescribed number of drops into the conjunctival sac.
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Correct Answer is C
Explanation
Choice A reason:
Promoting oral hygiene is important for preventing infection and maintaining overall health, especially after surgery involving the mouth. However, it is not the immediate priority in the postoperative period.
Choice B reason:
Ensuring adequate nutrition is crucial for healing and recovery, but it is not the most urgent concern immediately after surgery. Nutritional needs can be addressed once the client is stable and the risk of complications has been minimized.
Choice C reason:
Preventing aspiration is the priority action. After surgery for a fractured mandible with intermaxillary fixation, the client is at high risk for aspiration due to the inability to open the mouth and clear secretions effectively. Aspiration can lead to serious complications such as pneumonia, making it the most critical concern.
Choice D reason:
Relieving the client’s pain is important for comfort and recovery, but it is not the highest priority immediately after surgery. Pain management should be addressed once the client’s airway and breathing are secure.
Correct Answer is C
Explanation
Choice A: Exophthalmos
Exophthalmos, or bulging eyes, is not a typical symptom of hypothyroidism. Instead, it is commonly associated with hyperthyroidism, particularly Graves’ disease. In hypothyroidism, the thyroid gland is underactive, leading to a different set of symptoms.
Choice B: Photophobia
Photophobia, or sensitivity to light, is not a common symptom of hypothyroidism. While hypothyroidism can cause a variety of symptoms, photophobia is more often associated with conditions affecting the eyes or the nervous system.
Choice C: Lethargy
Lethargy, or extreme fatigue, is a common symptom of hypothyroidism. When the thyroid gland does not produce enough thyroid hormones, the body’s metabolism slows down, leading to feelings of tiredness and lack of energy. This is one of the hallmark symptoms of hypothyroidism and can significantly impact a person’s daily life.
Choice D: Weight Loss
Weight loss is not typically associated with hypothyroidism. In fact, weight gain is more common due to the slowed metabolism caused by an underactive thyroid. Individuals with hypothyroidism often experience difficulty losing weight and may gain weight even with a normal diet and exercise routine.