A miotic medication has been prescribed for a client with acute angle-closure glaucoma. The client asks the nurse about the purpose of the medication. Which response should the nurse provide to the client?

"The medication will help block the neural impulses that are sent to the muscles in the eye."

"The medication will help dilate the pupil to allow drainage of fluid to occur."

"The medication causes the pupil to constrict, opening the angle where the iris meets the cornea."

"The medication pulls excess aqueous humor from the eye, into the bloodstream."

Answer and Explanation

The Correct Answer is C

A.   This statement is not accurate in the context of miotic medications. Miotic drugs do not work by blocking neural impulses to the muscles. Instead, they directly affect the eye's pupil size and fluid dynamics. This response does not correctly describe the action of miotic agents.
B.   This response is incorrect because miotic medications actually constrict the pupil, not dilate it. In acute angle-closure glaucoma, dilation of the pupil would worsen the condition by further blocking the drainage angle. Miotics are used to constrict the pupil, which helps open the angle between the iris and the cornea, thereby facilitating fluid drainage.

C.   Miotic medications cause the pupil to constrict (miosis), which helps in opening the narrow angle between the iris and the cornea. In acute angle-closure glaucoma, the angle is closed or narrow, preventing proper drainage of aqueous humor. By constricting the pupil, miotic medications can help to relieve this obstruction and allow better drainage of fluid, thereby reducing intraocular pressure.
D.   This statement is incorrect regarding the action of miotic medications. Miotic drugs do not pull aqueous humor into the bloodstream. Their primary effect is on the pupil's size and the angle of the eye to improve drainage. Medications that reduce aqueous humor production or increase its outflow, such as carbonic anhydrase inhibitors or prostaglandin analogs, are responsible for these actions

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Correct Answer is C

Explanation

A. Casts in the urine are typically associated with kidney problems, such as glomerulonephritis or kidney infections, rather than biliary obstruction. Casts are formed from proteins or cells in the renal tubules and are not related to bile duct obstruction or cholelithiasis.
B. Dark, tarry stools are indicative of upper gastrointestinal bleeding and the presence of digested blood in the stool. This condition, known as melena, is not typically associated with obstruction of the common bile duct due to cholelithiasis.
C. Jaundice is a common and significant finding in cases of obstruction of the common bile duct due to cholelithiasis. When the bile duct is obstructed, bilirubin, which is a component of bile, accumulates in the bloodstream because it cannot be properly excreted into the intestine.
D. Pain from cholelithiasis (gallstones) typically occurs in the right upper quadrant, not the left. The right upper quadrant pain is often associated with gallbladder inflammation or bile duct obstruction.

A. Creatinine 1.2 mg/dL B. 24-hour urine output 1,800 mL C. White blood cell count (WBC) 13,500/mm3 D. Blood urea nitrogen (BUN) 18 mg/dL

Correct Answer is C

Explanation

A creatinine level of 1.2 mg/dL is within the upper range of normal but may be slightly elevated depending on the baseline level pre-transplant and individual patient factors. For a client 3 months post- transplant, this level could indicate stable kidney function or a mild increase but is not necessarily indicative of a significant complication.
B.A 24-hour urine output of 1,800 mL is within the normal range for adults (about 1,000 to 2,000 mL per day). This level of urine output suggests that the transplanted kidney is functioning adequately in terms of urine production.
C. An elevated white blood cell count of 13,500/mm³ could indicate an infection or inflammation. This finding is relevant in the context of post-transplant care because patients are at increased risk for infections due to immunosuppressive therapy and the surgical procedure. An elevated WBC count could also suggest an acute rejection episode, as rejection can cause inflammation and an immune response.
D. A BUN level of 18 mg/dL is within the normal range but on the higher end. It might suggest some level of kidney impairment, but it is not necessarily indicative of a severe complication on its own.

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A miotic medication has been prescribed for a client with acute angle-closure glaucoma. The client asks the nurse about the purpose of the medication. Which response should the nurse provide to the client?

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