chapter 53 otic and opthalmic prep

A nurse has taught the client about acetazolamide. Which statement indicates the client needs further instruction?

"I will dissolve the tablet in sterile normal saline and apply it to my eye."

Which of the following is an example of a beta-adrenergic blocking ophthalmic drop? (Choose one)

Betaxolol (Betoptic)

Which characteristic does both atropine and phenylephrine share?

Mydriatic effects

What ocular condition is generally treated with a prescription for ciprofloxacin eyedrops?

conjunctivitis

The nurse should explain that normal intraocular pressure (IOP) results from which physiological process?

consistent production and resorption of tears

A client is prescribed ciprofloxacin. Which statement by the nurse is correct regarding the adverse effects of the medication?

"Adverse effects include nausea, vomiting, and tendinitis or tendon rupture."

A nurse received a small bottle of drops that read "for otic use only." What part of the body does the nurse know that these drops are to be used in?

Ear

A client, diagnosed with recurrent epithelial keratitis, is prescribed trifluridene. Which statement by the client demonstrates a need for additional medication teaching?

"I will allow my friend to apply the medication to my eyelid."

A client is diagnosed with an eye infection and prescribed ciprofloxacin. Which statement by the client warrants additional instruction regarding appropriate home care instructions?

"I will change my contacts each morning."

The nurse is educating a client diagnosed with otitis externa about the prescribed otic medication neomycin-polymyxin B-hydrocortisone. Which statement made by the client establishes the need for further clarification?

"I will wear a cotton ball during swimming, and use a blow dryer on low setting to dry my ear canal."

A nurse asks a student nurse how intraocular pressure (IOP) is maintained. What statement indicates that the student nurse has an appropriate understanding of this process?

"It is a balance between the production and drainage of aqueous humor."

A client is prescribed natamycin. What statement should be included in the teaching about the medication?

"It is used for intraocular fungal infection."

What statement related to the action of timolol should be included in the teaching plan?

"It reduces aqueous humor production while increasing its outflow."

A pregnant woman calls the clinic and asks if it is suitable to use ofloxacin otic drops that she used prior to pregnancy for a current ear infection. What would be an appropriate response from the nurse?

"The effects of ofloxacin in pregnancy are not known, so the drug should not be used while pregnant."

The nurse is educating a client diagnosed with open-angle glaucoma about the prescribed ophthalmic medication bimatoprost. Which statement made by the client establishes the need for further clarification?

"The soft contacts may remain in place when administering the medication."

What health education should the nurse provide to a client prior to the instillation of atropine eyedrops?

"These drops might sting a little bit, and they will make you temporarily sensitive to light."

A nurse is administering two different types of eyedrops to a client. What is the minimal time the nurse should wait between the instillations?

5 minutes

To ensure drops stay in the eye and avoid systemic absorption of the medication, the nurse should instruct the client to do what after instilling eyedrops?

Apply finger pressure over the lacrimal sac for 1 to 2 minutes after instillation.

An older adult client is brought to the clinic accompanied by his daughter. The daughter reports her father is having difficulty hearing recently. The nurse knows this might be occurring for what reason?

Cerumen is thicker in older adults and accumulates, causing difficulty hearing.

Some eyedrops contain a preservative absorbed by soft contacts. The nurse recognizes that clients should be cautioned about instilling eyedrops containing what substance if they wear soft contacts?

Benzalkonium hydrochloride

A client is to receive therapy for newly diagnosed glaucoma. The nurse is reviewing the client's medical history. The nurse is aware that timolol is contraindicated in individuals with a history of:

asthma.

A nurse has completed an assessment of a client whose pupils have been medically dilated. How should the nurse document this finding in the client's medical record?

Bilateral mydriasis noted

The practitioner has determined that a beta blocker is contraindicated in the client. The nurse anticipates the client will be prescribed what for glaucoma?

Brimonidine (Alphagan P)

Which of the following is an example of a corticosteroid ophthalmic drop? (Choose one)

Dexamethasone (Maxidex)

A nurse is talking to a client who has just been prescribed an ophthalmic medication. Which of the following teaching points would be important for the nurse to teach the client? Select all that apply.

If solution is discolored, do not use it. Wash hands thoroughly before placing drops in eye. Do not touch tip of dropper, bottle, or tube.

A client, diagnosed with ocular hypertension and prescribed an alpha2-adrenergic agonist eyedrop asks what the medication is expected to do. What is the basis for the nurse's explanation of the action of such a medication?

It is intended to reduce the production of aqueous humor and so decreases intraocular pressure (IOP).

If a nurse needs to administer otic preparations in both of the client's ears, how long should the nurse wait to place drops in the second ear?

at least 5 minutes

A 2-year-old with an ear infection is seen in the clinic. The health care provider orders ear drops and asks the nurse to teach the mother the correct way to instill them. Which would be correct to tell the mother?

Pull the pinna down and back before instilling the drops.

A nurse is preparing to apply a client's scheduled dose of bimatoprost. To reduce this client's risk of infection during administration, what action should the nurse take?

preventing the applicator from coming in contact with any surface

What is the proper order for the steps required to administer ear drops to a child?

Wash hands. Tilt the head toward the opposite shoulder. Pull the superior aspect of the auricle upward. Instill the ear drops in the ear canal. Lie on the opposite side of administration. Place a cotton ball in the ear canal.

A 10-year-old client is diagnosed with acute otitis media. What does the nurse anticipate the prescriber to order?

amoxicillin

When describing the various ingredients used in otic preparations, the nurse understands that antipyrine is used in which otic preparations?

analgesic

A client asks the nurse about herbs that might be beneficial in promoting eye health. Which herbal remedy would the nurse suggest? Select all that apply.

bilberry whortleberry huckleberry

When educating a group of older adults about glaucoma, the nurse should identify what classic characteristics of this disorder? Select all that apply.

blurred vision halos around lights loss of peripheral vision

Which is an example of an alpha-2-adrenergic agonist ophthalmic drop?

brimonidine

A miotic has been prescribed for a client. The nurse caring for this client should know that the drug should be administered cautiously to a client with a history of which condition? Select all that apply.

cardiac failure cardiac failure bronchial asthma urinary tract infection

A nurse is caring for a client who is receiving an antiviral ophthalmic. The nurse suspects that the client is experiencing a systemic adverse reaction based on which assessment finding?

photophobia

A nursing student is studying medical terminology and identifies which of the following correctly to mean constriction of the pupil?

miosis

A client has been diagnosed with a fungal infection in the right eye. The ophthalmologist plans to order which drug to treat this infection?

natamycin

An 8-year-old client is diagnosed with external otitis media. What agent is commonly prescribed?

neomycin-polymyxin B

A client with glaucoma asks the nurse why it is necessary to use drops every day. The nurse responds that the drops help lower intraocular pressure (IOP) and that if IOP remains high, which complications can develop? (Select all that apply.)

optic nerve damage visual loss blindness

The nurse identifies which as the correct method to instill ear drops in the adult client?

pull the pinna of the ear up and back

The nurse understands that when instilling otic preparations into the external auditory canal, the drug is being used for which of the following reasons? (Select all that apply.)

relieve pain treat infection treat inflammation aid in the removal of cerumen

A client has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the client to look for side effects from the prolonged use of the antibiotic and informs the client that this is known as:

superinfection.