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 C
Explanation
A) Application of a transdermal patch: The application of transdermal patches is typically within the scope of licensed nursing personnel due to the need for appropriate placement, potential absorption risks, and proper documentation. This task requires understanding of the medication's effects, which is outside the scope of a UAP’s duties.
B) Use of MDIs: Metered-dose inhalers (MDIs) involve medication administration, which requires client assessment, monitoring of technique, and evaluation of response to therapy. These are skills that a UAP is not trained to handle, as they fall within a licensed nurse's responsibilities.
C) Application of a skin barrier cream to the perineal area: UAPs can apply non-medicated skin barrier creams to protect the skin in the perineal area, as it is a basic care activity. This task does not require specialized training in medication administration and is within the typical role of a UAP for maintaining skin integrity.
D) Instillation of eye drops: Administering eye drops involves medication administration, which includes proper technique, dosing, and monitoring for side effects, making it a task for licensed nursing personnel rather than a UAP.
E) Inserting rectal medications: Rectal medication insertion is a more advanced procedure that requires medication administration knowledge, correct positioning, and monitoring, which are responsibilities designated for licensed nursing staff, not a UAP.
F) Instillation of ear drops: Administering ear drops requires an understanding of dosing, technique, and monitoring for adverse effects, all of which are beyond the scope of practice for UAPs and are typically carried out by licensed nursing staff.
G) Inserting vaginal medications: Vaginal medication administration requires understanding of proper technique and monitoring for therapeutic effects or side effects, which necessitates a licensed nurse’s assessment skills and should not be delegated to a UAP.
Correct Answer is C
Explanation
A) 6 weeks from the start of using the inhaler: This option is not accurate. The timing for refilling should be based on the actual usage rather than a fixed period, and 6 weeks may not align with the client’s actual consumption.
B) As soon as the client leaves the hospital: This option is premature. The client does not need to refill the inhaler immediately upon discharge since they may not have used many puffs yet.
C) 50 days after discharge: This is the correct answer. If the client is to administer 2 puffs twice daily, that totals 4 puffs per day. With 200 puffs in the inhaler, the inhaler would last for 50 days (200 puffs ÷ 4 puffs per day = 50 days). Advising the client to refill the medication approximately 50 days after discharge ensures they have enough medication available.
D) When the inhaler is half empty: This option could lead to refilling too early or too late, depending on the individual’s usage pattern. Advising to refill based on a specific number of days or puffs used provides a more precise recommendation.