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 B
Explanation
Choice A reason: Draw sheet:
A draw sheet can be used to assist in repositioning a patient, but it is not the most effective method for turning a client who has undergone spinal fusion. The primary concern is to maintain spinal alignment, which is best achieved through the log roll technique.
Choice B reason: Log roll:
The log roll technique is the preferred method for turning patients who have had spinal surgery. This technique involves moving the patient as a single unit, keeping the spine in alignment to prevent any twisting or bending that could disrupt the surgical site. It is especially important for obese patients to ensure that the spine remains stable during movement.
Choice C reason: Sliding board:
A sliding board is typically used to assist with transfers from one surface to another, such as from a bed to a wheelchair. It is not suitable for turning a patient in bed, particularly one who has had spinal surgery.
Choice D reason: Hoyer lift:
A Hoyer lift is a mechanical device used to lift and transfer patients who are unable to move themselves. While it can be useful for transferring patients, it is not designed for turning patients in bed and does not provide the necessary support to maintain spinal alignment during a turn.
Correct Answer is D
Explanation
Choice A: You Can Expect Swelling of the Ankles While Taking This Medication
Swelling of the ankles, or peripheral edema, is a known side effect of verapamil. This calcium channel blocker can cause fluid retention, leading to swelling in the lower extremities. While this is a common side effect, it is not an instruction that the nurse should include in discharge teaching. Instead, the nurse should inform the client to report any significant swelling to their healthcare provider.
Choice B: Do Not Take This Medication on an Empty Stomach
Verapamil can be taken with or without food, but taking it with food may help reduce stomach upset. Therefore, the instruction to avoid taking it on an empty stomach is not strictly necessary. The nurse should advise the client to follow their healthcare provider’s specific instructions regarding medication administration.
Choice C: Limit Your Fluid Intake to Meal Times
Limiting fluid intake to meal times is not a standard recommendation for clients taking verapamil. Adequate hydration is important for overall health, and there is no specific reason to restrict fluid intake while on this medication. The nurse should encourage the client to maintain a balanced fluid intake throughout the day.
Choice D: Increase Your Daily Intake of Dietary Fiber
Increasing daily intake of dietary fiber is a beneficial instruction for clients taking verapamil. Verapamil can cause constipation as a side effect, and a high-fiber diet can help mitigate this issue. Foods rich in fiber, such as fruits, vegetables, and whole grains, can promote regular bowel movements and improve digestive health.
