A nurse is preparing to administer an ophthalmic medication to a client.
Which of the following actions should the nurse plan to take?
Instill the ophthalmic medication directly on the client's cornea.
Ask the client to tightly squeeze their eyes shut after the instillation.
Clean the client's eye from the outer canthus to the inner canthus before instillation.
Apply pressure to the client's nasolacrimal duct after instillation.
The Correct Answer is D
Choice A rationale
Instilling ophthalmic medication directly on the cornea can cause irritation and discomfort. Medications should be administered in the conjunctival sac.
Choice B rationale
Asking the client to tightly squeeze their eyes shut after instillation can expel the medication, reducing its effectiveness. Gentle closing of the eyes is recommended.
Choice C rationale
Cleaning the eye from the outer canthus to the inner canthus is not the proper method. The correct method is to clean from the inner canthus to the outer canthus to avoid contaminating the inner eye.
Choice D rationale
Applying pressure to the nasolacrimal duct after instillation helps prevent the medication from draining into the nasolacrimal system, ensuring better absorption in the eye.
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Correct Answer is A
Explanation
Choice A rationale
Reflex incontinence is caused by neurological impairment or damage, such as spinal cord injury, which results in a loss of voluntary control over urination. The bladder muscle contracts involuntarily, causing urine leakage.
Choice B rationale
Overflow incontinence occurs when the bladder cannot empty properly, leading to frequent or constant dribbling of urine. It is not typically associated with nerve damage from spinal cord injury.
Choice C rationale
Stress incontinence is caused by physical movement or activity—such as coughing, sneezing, or heavy lifting—that puts pressure on the bladder, leading to urine leakage. It is not related to nerve damage or neurological conditions.
Choice D rationale
Urge incontinence is characterized by a sudden, intense urge to urinate, followed by involuntary urine leakage. It is usually caused by an overactive bladder or other conditions affecting bladder function, but not directly by nerve damage from spinal cord injury.
Correct Answer is B
Explanation
Choice A rationale
Aluminum-containing antacids often cause constipation due to their effect on bowel motility, not diarrhea. They work by neutralizing stomach acid but can lead to decreased bowel movements.
Choice B rationale
Magnesium-containing antacids can cause diarrhea as a side effect. They work by neutralizing stomach acid, and the excess magnesium in the intestines can cause loose stools or diarrhea.
Choice C rationale
Antibiotics can cause diarrhea by disrupting the balance of normal gut bacteria. This disruption can lead to overgrowth of harmful bacteria, such as Clostridium difficile, which can cause diarrhea.
Choice D rationale
Anticholinergics/antispasmodics typically cause constipation rather than diarrhea. They inhibit the parasympathetic nervous system, which slows down gut motility.
Choice E rationale
Opioid narcotics can cause constipation because they slow down the movement of the intestines. They do this by binding to opioid receptors in the gut, which decreases peristalsis.