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: Bradycardia:
Bradycardia, or a slow heart rate, is not typically associated with diabetes insipidus. Diabetes insipidus primarily affects the body’s ability to regulate fluid balance, leading to excessive urination and thirst. Bradycardia is more commonly related to conditions affecting the heart or the autonomic nervous system.
Choice B reason: Hyperglycemia:
Hyperglycemia, or high blood sugar, is a hallmark of diabetes mellitus, not diabetes insipidus. Diabetes insipidus is characterized by the kidneys’ inability to concentrate urine, leading to large volumes of dilute urine and increased thirst3. Hyperglycemia is not a symptom of diabetes insipidus.
Choice C reason: Dehydration:
Dehydration is a common and significant finding in diabetes insipidus. Due to the excessive loss of water through urine, individuals with diabetes insipidus often experience severe thirst and dehydration if they do not consume enough fluids to compensate for the loss. This is a key symptom that helps differentiate diabetes insipidus from other conditions.
Choice D reason: Polyphagia:
Polyphagia, or excessive hunger, is typically associated with diabetes mellitus, particularly when blood sugar levels are high and the body’s cells are not receiving adequate glucose. In diabetes insipidus, the primary symptoms are related to fluid imbalance, such as excessive urination (polyuria) and thirst (polydipsia), rather than hunger.
Correct Answer is D
Explanation
Choice A reason:
A client with a tracheostomy tube attached to humidified oxygen is not typically at risk for hypokalemia. The primary concerns for these clients are maintaining a patent airway, preventing infection, and ensuring adequate humidification to prevent mucus plugging.
Choice B reason:
A client with an indwelling urinary catheter to gravity drainage is not specifically at risk for hypokalemia. The main risks for these clients include urinary tract infections and ensuring proper catheter care to prevent blockages.
Choice C reason:
A client with a chest tube to water seal is primarily at risk for complications related to the chest tube itself, such as infection, pneumothorax, or improper drainage. Hypokalemia is not a common risk associated with chest tubes.
Choice D reason:
A client with a nasogastric tube to suction is at risk for hypokalemia. Continuous suctioning can lead to the loss of gastric contents, which contain potassium, leading to a decrease in potassium levels in the body. This can result in hypokalemia, which needs to be monitored and managed appropriately.
