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:
Restricting the client’s oral fluid intake is not appropriate in this situation. Adequate fluid intake is essential to help flush out the bladder and prevent clot formation. Clients are usually encouraged to drink plenty of fluids to ensure proper hydration and urine flow.
Choice B reason:
Reminding the client that he might feel a constant urge to void is important. After a transurethral resection of the prostate (TURP), the presence of the catheter and continuous bladder irrigation can cause a sensation of needing to urinate. This is a common experience and reassuring the client helps manage their expectations and reduce anxiety.
Choice C reason:
Weighing the client every evening is not a standard intervention specifically related to TURP and continuous bladder irrigation. While monitoring weight can be important for overall health, it is not directly related to the immediate postoperative care of a TURP patient.
Choice D reason:
Monitoring the client’s urine output every 6 hours is important, but it should be done more frequently in the immediate postoperative period. Continuous bladder irrigation requires close monitoring to ensure that the irrigation fluid is flowing properly and that there are no blockages or complications.
Correct Answer is A
Explanation
Choice A: Wrap the stump with an elastic bandage in a figure-eight configuration
Wrapping the stump with an elastic bandage in a figure-eight configuration is a standard practice in postoperative care for below-the-knee amputations. This method helps to shape and shrink the residual limb, preparing it for a prosthesis fitting. The figure-eight wrap provides even compression, which helps to reduce swelling and promote proper healing. It also helps to prevent the formation of edema and ensures that the residual limb maintains a conical shape, which is ideal for fitting a prosthetic socket.
Choice B: Remove the elastic bandage and re-wrap the stump once per day
While it is important to regularly check and adjust the bandage, removing and re-wrapping the stump only once per day may not be sufficient. The bandage should be checked more frequently to ensure it remains properly positioned and provides consistent compression. In some cases, it may need to be adjusted multiple times a day to maintain the desired level of compression and to prevent any issues such as slippage or uneven pressure.
Choice C: Perform passive range of motion exercises once daily
Performing passive range of motion exercises is beneficial for maintaining joint flexibility and preventing contractures. However, these exercises should be performed more frequently than once daily, especially in the early postoperative period. Regular exercises help to maintain muscle strength, improve circulation, and promote overall mobility. The frequency and type of exercises should be tailored to the individual needs of the client and guided by a physical therapist.
Choice D: Secure the elastic bandage to the lowest joint
Securing the elastic bandage to the lowest joint is not recommended. The bandage should be wrapped in a way that provides even compression without restricting movement or circulation. The figure-eight configuration is preferred because it allows for better control of the compression and helps to shape the residual limb effectively. Securing the bandage to a joint can lead to discomfort and may impede proper blood flow.