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: Assist the client to sit upright in a chair for 4 hours at a time:
While it is important to mobilize patients after surgery, sitting upright for 4 hours at a time is excessive and can cause discomfort and strain on the surgical site. Early postoperative care focuses on gradual mobilization and avoiding prolonged positions that could stress the spine.
Choice B reason: Expect clear drainage on the spinal dressing:
Clear drainage on the spinal dressing is not typical and could indicate a cerebrospinal fluid (CSF) leak, which is a serious complication. Any unexpected drainage should be reported to the healthcare provider immediately.
Choice C reason: Log roll the client every 2 hours:
Log rolling is a technique used to turn patients while keeping the spine in alignment. This method is crucial for patients who have undergone spinal surgery to prevent twisting or bending of the spine, which could disrupt the surgical site and impede healing. Regular repositioning also helps prevent pressure ulcers.
Choice D reason: Perform neurological checks every 8 hours:
Neurological checks are essential after spinal surgery to monitor for any changes in sensation, movement, or function. However, these checks are typically performed more frequently than every 8 hours, especially in the immediate postoperative period.
Correct Answer is D
Explanation
Choice A: Take the Medication with Orange Juice
Taking betamethasone with orange juice is not specifically recommended. While orange juice can help with the taste of some medications, it does not have any particular benefit for betamethasone. Additionally, citrus juices can sometimes interfere with the absorption of certain medications.
Choice B: Take the Medication Between Meals
Taking betamethasone between meals is not advised. This medication can cause stomach upset, and taking it on an empty stomach can exacerbate this issue. It is generally recommended to take corticosteroids with food to minimize gastrointestinal discomfort.
Choice C: Take the Medication on an Empty Stomach
Taking betamethasone on an empty stomach is not recommended for the same reasons as above. It can lead to stomach irritation and discomfort. Taking the medication with food or milk helps to reduce these side effects.
Choice D: Take the Medication with Milk
Taking betamethasone with milk is the correct instruction. Milk can help to buffer the stomach lining and reduce the risk of gastrointestinal irritation, which is a common side effect of corticosteroids. This practice helps to ensure that the medication is tolerated well by the client.
