Chapter 57 - Ophthalmic Drugs
What statement by a patient indicates a need for further teaching regarding proper administration of eyedrops? "I will be careful not to touch my eye with the dropper." "I will rinse the eyedropper with tap water after each use." "I will wash my hands thoroughly with soap and water before putting in the eyedrops." "I will press gently against the inner corner my eye after I administer the eyedrops."
"I will rinse the eyedropper with tap water after each use." It is important to maintain sterility of the eyedrop container; therefore, it should not be rinsed. The cap should be put immediately back on the container.
A patient is prescribed epinephrine eyedrops for treatment of chronic open-angle glaucoma. The patient complains of burning with instillation of the drops. What statement is the nurse's best response? "It is a normal sensation because the eyedrops reduce inflammation." "This will occur if the drop is not placed in the correct area of the eye." "That should not occur. Contact your health care provider immediately." "This is a typical adverse effect and may lessen over time."
"This is a typical adverse effect and may lessen over time." Both epinephrine and dipivefrin are used to reduce elevated intraocular pressure in the treatment of chronic open-angle glaucoma, either as initial therapy or as long-term therapy. Adverse effects of the sympathomimetic mydriatics are primarily limited to ocular effects and include burning, eye pain, and lacrimation. Such effects are usually temporary and may subside as the patient grows accustomed to the medication.
The nurse is educating a patient with a new diagnosis of open-angle glaucoma on the adverse effects of the indirect-acting miotic eyedrops prescribed. What will the nurse include in the teaching as possible adverse effects? (Select all that apply.) Select all that apply. Blurred vision Decreased nighttime vision Farsightedness Paralysis of eyelids Stinging on instillation
Blurred vision, Decreased nighttime vision, Stinging on instillation Adverse effects are more likely to occur with indirect-acting miotics because they have longer lasting effects. Effects include blurred vision, drug-induced myopia (nearsightedness), and accommodative spasms. Such effects are secondary to contraction of the ciliary muscle. Miotic drugs also cause vasodilation of blood vessels supplying the conjunctiva, iris, and ciliary body, which may lead to vascular congestion and ocular inflammation. Other undesirable effects include temporary stinging upon drug instillation, reduced nighttime or low-light vision, conjunctivitis, lacrimation (tearing), twitching of the eyelids (blepharospasm), and eye or eyebrow pain.
The patient is prescribed olopatadine for treatment of allergic conjunctivitis. The nurse knows the medication works though what action? Inhibits release of mast cells Competes at histamine receptor sites Stimulates the dilator muscle to contract Lubricates the surface of the eye
Competes at histamine receptor sites Patanol is an ocular antihistamine and works by competing at histamine receptor sites.
An infant born with increased intraocular pressure is likely to be diagnosed with what type of glaucoma? Pigmentary Open angle Congenital Angle closure
Congenital An infant may be born with congenital glaucoma.
Parasympathomimetic ophthalmic drugs such as pilocarpine reduce intraocular pressure in the treatment of glaucoma by what mechanism of action? Decrease in drainage of aqueous humor Miosis Cause the pupils to get larger Mydriasis
Miosis Pilocarpine is a direct-acting parasympathomimetic drug that is used as a miotic in the treatment of open-angle glaucoma. Miosis causes pupillary constriction, increasing the outflow of aqueous humor.
The nurse is educating a patient who was administered atropine sulfate solution for an eye examination. The nurse includes what information in the education? Instruct that a common adverse effect is dry eyes. Advise that pupils may remain small for 12 hours after administration. Instruct to wait 72 hours to wear contact lenses. Encourage use of sunglasses to decrease sunlight sensitivity.
Encourage use of sunglasses to decrease sunlight sensitivity. The medication is a mydriatic and is used to dilate the pupils for eye exams. The patient may have increased sunlight sensitivity and should wear sunglasses until the pupils return to normal size.
At the time of birth, infants are often treated with erythromycin eye ointment as prophylactic treatment against what possible organism? Aspergillus fumigatus Malassezia furfur Neisseria gonorrhoeae Candida albicans
Neisseria gonorrhoeae Erythromycin eye ointment is indicated for the treatment of neonatal conjunctivitis caused by Chlamydia trachomatis and for the prevention of eye infections in newborns that may be caused by N. gonorrhoeae or other susceptible organisms.
The nurse is providing education to a patient with a diagnosis of bilateral conjunctivitis (pink eye) who is prescribed sulfacetamide. What information in the patient history is important and would be reported immediately to the health care provider? The patient does not like eyedrops The patient is allergic to sulfa drugs. The patient wears colored soft contact lenses. The patient has never had pink eye before.
The patient is allergic to sulfa drugs. The other data are important for education and teaching; however, a patient allergic to sulfa drugs should not be prescribed a sulfa drug for treatment. The health care provider would need to be alerted immediately.
Sympathomimetic mydriatics have the potential to react with other drugs if sufficient topical absorption occurs. When given concurrently, drugs in what class may interact with the sympathomimetic mydriatics? Calcium channel blockers Oral contraceptives Thyroid hormones Nonsteroidal antiinflammatory drugs
Thyroid hormones With sufficient topical absorption, sympathomimetic mydriatics have the potential to react with other drugs. Cardiac dysrhythmias are potentiated when mydriatic drugs are given with halogenated anesthetics, cardiac glycosides, thyroid hormones, or tricyclic antidepressants.