When applying ophthalmic ointments, the nurse should: (Select all that apply.)
fill only the center of the conjunctival sac.
remove excess ointment from the lid with a cotton ball.
remove gloves and perform hand hygiene.
ask the client to roll the eye around and from side to side.
ask the client to close the eyelids tightly to distribute ointment.
Correct Answer : C,D,E
A) Fill only the center of the conjunctival sac: This option is incorrect. When applying ophthalmic ointment, the ointment should be placed along the entire length of the conjunctival sac, not just the center, to ensure proper distribution and effectiveness.
B) Remove excess ointment from the lid with a cotton ball: This action is not recommended. Instead of using a cotton ball, which may introduce fibers or contaminants, excess ointment should be gently wiped away with a clean tissue or cloth if necessary. However, it is generally best to avoid excess application in the first place.
C) Remove gloves and perform hand hygiene: This option is correct. After applying the ointment, the nurse should remove gloves and perform hand hygiene to prevent any potential contamination and maintain proper infection control practices.
D) Ask the client to roll the eye around and from side to side: This is a correct action. Encouraging the client to roll their eyes helps distribute the ointment evenly across the surface of the eye, enhancing its effectiveness.
E) Ask the client to close the eyelids tightly to distribute ointment: This option is also correct. Closing the eyelids helps spread the ointment over the conjunctival surface, ensuring better coverage and absorption of the medication.
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Correct Answer is D
Explanation
A) Cerumen or drainage is occluding the ear canal: While cerumen or drainage can cause discomfort, it is less likely to be the direct cause of dizziness following the administration of eardrops. Dizziness is more commonly associated with changes in pressure or temperature in the ear.
B) Too much pressure was applied during instillation, with subsequent injury to the eardrum: Although excessive pressure can lead to injury, the immediate symptom of dizziness after eardrop administration is more closely related to other factors, particularly temperature or positioning.
C) The client failed to remain in the side-lying position long enough: This option is incorrect because not maintaining the position may affect medication absorption but is unlikely to cause immediate dizziness and nausea.
D) The medication was too cold when it was administered: This is the most likely cause of the dizziness. Cold eardrops can cause a rapid change in temperature within the ear canal, potentially stimulating the vestibular system and leading to dizziness or vertigo. It is generally recommended to warm eardrops to body temperature before administration to minimize this risk.
Correct Answer is B
Explanation
A) Ask the client if he would prefer to give the medication to himself: While involving the client in their care is important, this option does not assess the client’s ability to safely take the medication. The nurse should first ensure that the client can swallow the medication safely.
B) Assess the swallowing reflex by offering a sip of water: This is the correct action. Assessing the swallowing reflex is essential, especially in older adults, to determine if they can safely swallow liquid medications without risk of aspiration.
C) Mix thoroughly in applesauce or pudding: This option is not appropriate unless specifically ordered or indicated. Mixing medications in food may not be suitable for all clients, and it can affect the medication's absorption or effectiveness. Additionally, it does not assess the client's swallowing ability.
D) Assess the ability to understand information relative to the medication: While this is important, it is secondary to ensuring that the client can physically take the medication safely. Assessing understanding can occur after confirming the client’s ability to swallow the medication.