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: Botulism is Acquired Through Direct Contact with an Infected Person
Botulism is not acquired through direct contact with an infected person. It is caused by a toxin produced by the bacterium Clostridium botulinum. The most common forms of botulism are foodborne, wound, and infant botulism. Foodborne botulism occurs when a person ingests food containing the toxin, while wound botulism occurs when the bacteria infect a wound and produce the toxin. Infant botulism occurs when infants ingest spores of the bacteria, which then grow and produce the toxin in their intestines.
Choice B: Notify the Centers for Disease Control and Prevention (CDC) When More Than Three Cases Are Confirmed
While notifying the CDC is crucial in the event of a botulism outbreak, the specific threshold for notification can vary. Generally, any suspected case of botulism should be reported to public health authorities immediately due to the severity of the disease and the potential for outbreaks. The CDC provides guidelines for reporting and managing botulism cases.
Choice C: Botulism Can Produce Paralysis Within 12 to 72 Hours Following Exposure
Botulism can indeed produce paralysis within 12 to 72 hours following exposure. The toxin affects the nervous system, leading to muscle paralysis. Early symptoms include weakness, dizziness, and dry mouth, followed by more severe symptoms such as blurred vision, difficulty swallowing, and muscle weakness. If left untreated, botulism can lead to respiratory failure and death.
Choice D: Vomiting and Diarrhea Are Expected Findings Following Exposure
Vomiting and diarrhea are not typical symptoms of botulism. The primary symptoms are related to muscle paralysis and neurological impairment. Gastrointestinal symptoms may occur in some cases of foodborne botulism, but they are not the hallmark signs of the disease.
Choice E: Botulism is a Toxin Found in Castor Beans
Botulism is not a toxin found in castor beans. The toxin found in castor beans is ricin, which is a different type of bioterrorism agent. Botulism is caused by the botulinum toxin produced by Clostridium botulinum bacteria.
Correct Answer is A
Explanation
Choice A reason: WBC count:
An elevated white blood cell (WBC) count is a common indicator of infection. The body produces more white blood cells to fight off infections, making this a key marker for identifying infections in patients with pressure ulcers. Monitoring WBC count helps in assessing the presence and severity of an infection, guiding appropriate treatment.
Choice B reason: BUN:
Blood urea nitrogen (BUN) levels are used to assess kidney function and hydration status. Elevated BUN levels can indicate dehydration or kidney dysfunction but are not specific indicators of infection. While important for overall health assessment, BUN is not directly related to detecting infections in pressure ulcers.
Choice C reason: Potassium:
Potassium levels are crucial for maintaining normal cellular function, particularly in the heart and muscles. Abnormal potassium levels can indicate issues such as kidney dysfunction or electrolyte imbalances but do not specifically indicate infection. Monitoring potassium is important for overall health but not for diagnosing infections in pressure ulcers.