A clinic nurse is giving instructions to a mother on the proper technique of applying ophthalmic ointment to her preschool-age child who has conjunctivitis. Which of the following should the nurse include in the instructions?
“Warm the ointment by placing the tube in glass of hot tap water”
"Discard the first bead of ointment before each application."
"Instruct your child to squeeze his eyes shut following application."
"Cleanse the eye with a wet cotton ball in a direction towards the inner canthus before applying the ointment."
The Correct Answer is B
the first bead of ointment may be contaminated with bacteria from the tip of the tube or the surrounding skin. Discarding this initial bead ensures that the subsequent application is sterile and reduces the risk of introducing infection into the eye.
A. Warming the ointment by placing the tube in hot tap water alters the consistency of the ointment and can potentially cause burns to the child's delicate eye tissue.
C. Instructing the child to squeeze his eyes shut following application is not necessary. The eyes should be closed gently
D. Cleansing the eye should be done from the inner corner moving outward
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Correct Answer is C
Explanation
Aspirin is a salicylate that has multiple effects. When taken in excess in susceptible individuals it can cause tinnitus due to salicylism. The client should be advised to report any tinnitus to the provider as this may be a sign of aspirin toxicity.
A. Black stool is the client signifies upper GI bleeding that should be monitored for and reported if it occurs
B. Aspirin tablets have a vinegar smell when hydrolysis has taken place and should not be taken at this point
D. Aspirin should be taken with meals or after meals
Correct Answer is D
Explanation
Status asthmaticus is an acute, life threatening exacerbation of asthma causes by bronchospasm on exposure to a trigger. Status asthmaticus can lead to respiratory failure. Short acting beta 2 agonists bind to beta 2 receptors on the airway epithelium causing bronchodilation and promotes air flow. They are used as first line due to their short onset of action.
A. Administering an inhaled glucocorticoid is used for long term control of inflammation in asthma but has no role in acute attacks
B. Identification of triggers is important but not a priority in status asthmaticus.
C. Obtaining a peak flow reading is useful but not a priority.
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