**** Chapter 38

The client asks the nurse which OTC medication will lubricate the eye and cause vasoconstriction. Which response by the nurse is correct? "Oxymetazoline (OcuClear)." "Betaxolol (Betaoptic)." "Polyvinyl alcohol (Liquifilm)." "Lanolin alcohol (Lacri-lube)."

"Oxymetazoline (OcuClear)." Oxymetazoline (OcuClear) is a lubricant that causes vasoconstriction.

The client complains of blurry vision after using pilocarpine (Isopto Carpine). Which explanation about the blurry vision is most appropriate by the nurse? "This is a common reaction, but should be temporary." "Use only half the dose, and monitor the results." "I will have the physician prescribe something different for you." "You have an allergy, and should stop using the drops."

"This is a common reaction, but should be temporary." Miotic agents such as piocarpine (Isopto Carpine) produce various responses in the eye, including dilation of the trabecular meshwork so that the canal of Schlemm can absorb more aqueous humor, thus decreasing intraocular pressure. Side effects are temporary, and include cycloplegia.

The client has been prescribed travoprost (Travatan). When does the nurse anticipate the maximum effect of this medication occurs? 12 hours after administration 4 hours after administration 2 hours after administration 6 hours after administration

12 hours after administration Travoprost (Travatan) is a prostaglandin. The maximum effect occurs 12 hours after administration. All the other choices are incorrect.

Which area of the eye is responsible for allowing aqueous humor to drain from the anterior chamber? 1. Ciliary body 2. Canal of Schlemm 3. Trabecular meshwork 4. Aqueous humor

2. Canal of Schlemm The canal of Schlemm is where the aqueous humor drains from the anterior chamber.

Neomycin and hydrocortisone (Cortisporin) may be used in combination to treat ear infections. What is the combined effect of these medications? Antipyretic and antifungal Anti-inflammatory and antibiotic therapy Antibiotic therapy with an analgesic Antibiotic and prophylactic therapy

Anti-inflammatory and antibiotic therapy Cortisporin is a combination of neomycin and hydrocortisone (antibiotics and glucocorticoids), and is used to treat general ear infections and inflammation.

What instructions are appropriate for the nurse to include when teaching a client ways to prevent "swimmer's ear"? Use of glucocorticoid drops to prevent inflammation Application of 2% acetic acid to the ear canal after swimming Gently cleaning the ear canal with a swab to remove water or debris Use of earwax-dissolving agents to help prevent irritation

Application of 2% acetic acid to the ear canal after swimming Applying 2% acetic acid to the ear canal after swimming acts as a drying agent and restores the ear canal to its normal acidic condition.Applying 2% acetic acid to the ear canal after swimming acts as a drying agent and restores the ear canal to its normal acidic condition.

To prevent systemic absorption of timolol (Timoptic), what administration instructions are appropriate for the nurse to include in the teaching? Apply pressure over the lacrimal sac for 1 minute. Wait 5 minutes before administering other ophthalmic solutions. Administer the eyedrop in the conjunctival sac. Remove contact lenses prior to administering eyedrops.

Apply pressure over the lacrimal sac for 1 minute. Applying pressure over the lacrimal sac for 1 minute will decrease systemic absorption. Waiting 5 minutes between medication administration will not decrease systemic absorption. Administering the medication in the conjunctival sac will not decrease systemic absorption. Removing contact lenses prior to administering the medication will not decrease systemic absorption.

In the anterior chamber of the eye, what is the medical term for the watery fluid that is found here? Ciliary body Canal of Schlemm Trabecular meshwork Aqueous humor

Aqueous humor A watery fluid called aqueous humor is found in the anterior cavity of the eye. Ciliary body is incorrect because the fluid is known as aqueous humor. Canal of Schlemm is incorrect because the fluid is known as aqueous humor. Trabecular meshwork is incorrect because the fluid is known as aqueous humor.

The nurse is providing education to a client with a history of earwax buildup. Which medication does the nurse include in the teaching session? Acetic acid and hydrocortisone (Vosol HC) Ciprofloxacin hydrochloride and hydrocortisone (Cipro HC) Carbamide peroxide (Debrox) Polymyxin B, neomycin, and hydrocortisone (Cortisporin)

Carbamide peroxide (Debrox) Carbamide peroxide (Debrox) is used to soften, loosen, and remove excessive earwax. The medication is available over the counter. Acetic acid and hydrocortisone (Vosol HC) are used to treat ear infections. Ciprofloxacin hydrochloride and hydrocortisone (Cipro HC) are used to treat ear infections. Polymyxin B, neomycin, and hydrocortisone (Cortisporin) are used to treat ear infections.

Which medications decrease the formation of aqueous humor? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. Carbonic anhydrase inhibitors Alpha2-adrenergic agents Osmotic diuretics Prostaglandins Beta-adrenergic blockers

Carbonic anhydrase inhibitors Alpha2-adrenergic agents Osmotic diuretics Beta-adrenergic blockers Beta-adrenergic blockers, alpha2-adrenergic agents, carbonic anhydrase inhibitors, and osmotic diuretics are drug classes that decrease the formation of aqueous humor. Prostaglandins increase the outflow of aqueous humor.

Which medication does the nurse anticipate for a client who will undergo an ophthalmic examination? Antimicrobials and local anesthetics Local anesthetics and NSAIDs Corticosteroids and antibiotics Cycloplegics and mydriatics

Cycloplegics and mydriatics Cycloplegic drugs relax ciliary muscles and mydriatic drugs dilate the pupils; these are specifically designed for ophthalmic examinations. Corticosteroids, antibiotics, and local anesthetics are used to treat infections, inflammation, and minor irritations of the eye.

A client has been prescribed latanoprost (Xalatan). The nurse informs the client regarding potential side effects. Which side effect is not appropriate for the nurse to include in the client teaching? Decreased pigmentation Dryness Photophobia Heightened pigmentation

Decreased pigmentation Decreased pigmentation is not a side effect of latanoprost. Dryness is a side effect of latanoprost. Photophobia is a side effect of latanoprost. Heightened pigmentation is a side effect of latanoprost.

What is the most appropriate explanation as to why dipivefrin hydrochloride (Propine) effectively decreases intraocular pressure? The exact mechanism is not fully understood. It decreases the formation of aqueous humor. It reduces plasma volume very quickly. It converts to epinephrine and increases outflow of aqueous humor.

It converts to epinephrine and increases outflow of aqueous humor. Miotic agents such as piocarpine (Isopto Carpine) produce various responses in the eye, including dilation of the trabecular meshwork so that the canal of Schlemm can absorb more aqueous humor, thus decreasing intraocular pressure. Side effects are temporary, and include cycloplegia.

The nurse is caring for a client with open-angle glaucoma. What are the characteristics of this disorder the nurse must be aware of when providing care? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. It is caused by impact injury. It is the most common type of glaucoma. Intraocular pressure develops slowly. The iris does not cover trabecular meshwork. Intraocular pressure develops quickly.

It is the most common type of glaucoma. Intraocular pressure develops slowly. The iris does not cover trabecular meshwork. Open-angle, or chronic simple, glaucoma is the most common type of glaucoma. With this disorder, intraocular pressure develops more slowly.

The nurse is caring for a client who is experiencing inflammation that involves the middle ear. What is the appropriate medical term for the nurse to include in the documentation for this client? Swimmer's ear Mastoiditis Otitis media Otitis externa

Otitis media Otitis media is inflammation of the middle ear. Swimmer's ear is incorrect. Otitis externa is most commonly called "swimmer's ear," and involves the outer ear. Mastoiditis is inflammation of the mastoid sinus.

The nurse is caring for a client with closed-angle glaucoma. What are the characteristics of this disorder the nurse must be aware of when providing care? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. It is caused by stress. It is the most common type of glaucoma. It is caused by impact injury. The pressure develops slowly, over time. The pressure develops quickly.

It is the most common type of glaucoma. It is caused by impact injury. The pressure develops slowly, over time. Closed-angle glaucoma, sometimes referred to as acute glaucoma, is usually caused by stress, impact injury, or medications. Pressure inside the anterior chamber increases suddenly because the iris is pushed over the area where the aqueous fluid normally drains. Symptoms include intense headaches, difficulty concentrating, bloodshot eyes, and blurred vision. Symptoms of closed-angle glaucoma occur quickly.

A client has been prescribed timolol (Timoptic). When does the maximum therapeutic effect occur for the medication? It takes 6-8 weeks. It begins immediately. It takes 2-4 weeks. It takes 1-2 weeks.

It takes 2-4 weeks Timolol (Timoptic) is a beta-adrenergic blocker. Treatment can require 2-4 weeks for maximum therapeutic effect. The other answer options are incorrect.

Which medications increase the outflow of aqueous humor? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. Miotics Sympathomimetics Prostaglandins Beta blockers Calcium channel blockers

Miotics Sympathomimetics Prostaglandins Drugs increasing the outflow of aqueous humor include miotics, sympathomimetics, and prostaglandins.

Which medications are appropriate for minor irritation and injury? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected. NSAIDs Diphenhydramine HCl (Benadryl) Antimicrobials Local anesthetics Insulin (Humulin R)

NSAIDs Antimicrobials Local anesthetics Drugs for minor irritation and injury come from a broad range of classes, including antimicrobials, local anesthetics, glucocorticoids, and NSAIDs.

The nurse is reviewing a medication administration record. Which medication from the list is considered a mydriatic agent? Phenylephrine (Neo-Synephrine) Cyclopentolate (Cyclogyl) Atropine sulfate (Isopto Atropine) Scopolamine hydrobromide (Isopto Hyoscine)

Phenylephrine (Neo-Synephrine) Phenylephrine (Neo-Synephrine) is a mydriatic. Cyclopentolate (Cyclogyl) is an anticholinergic. Atropine sulfate (Isopto Atropine) is an anticholinergic. Scopolamine hydrobromide (Isopto Hyoscine) is an anticholinergic.

The nurse is caring for a client who is diagnosed with glaucoma. The client wants to know why this condition can lead to blindness. What is the best response by the nurse? The fluid in the eye blocks the optic nerve. Pressure around the optic nerve builds over time. The optic nerve cannot transmit signals with glaucoma. The optic nerve atrophies.

Pressure around the optic nerve builds over time. Over time, pressure around the optic nerve can build, leading to blindness. In some cases, eye injury can be sudden, but in most cases it is gradual.

Following an extensive eye examination where a mydriatic agent was utilized, which nursing diagnosis is most appropriate for the client? Pain, related to chemical agents Risk for injury, related to visual acuity deficits Self-care deficit, related to impaired vision Deficient knowledge, related to disease process

Risk for injury, related to visual acuity deficits Mydriatics cause temporary vision impairments, including blurred vision. Following such examinations, clients should be careful with driving or operating machinery while their vision is affected.

The client has been diagnosed with acute glaucoma. What are the common causes for this condition? Trauma or hemorrhage Increased intracranial pressure Decreased intraocular pressure Diabetes mellitus or renal disease

Trauma or hemorrhage Glaucoma, acute or chronic, is characterized by increased pressure inside the eyeball, termed intraocular pressure. The flow of aqueous humor becomes blocked, and over time, pressure around the optic nerve can build, leading to blindness. Closed-angle glaucoma or acute glaucoma is often caused by head trauma, cataracts, tumors, or hemorrhage.

What instruction is appropriate for a client who wants to clean the ear canal? Use a bulb syringe approved for removing debris and cold water. Never attempt to clean the ear canal at home. Use a bulb syringe approved for removing debris and warm water. Use a cotton swab.

Use a bulb syringe approved for removing debris and warm water. Rather than placing objects like cotton swabs in the ear canal, use a bulb syringe approved for removing debris and warm water.

Canal of Schlemm

duct in the anterior chamber that carries filtered aqueous humor to the veins and bloodstream