A nurse is caring for a client who has a chlamydial infection and a new prescription for doxycycline. The client reports nausea and vomiting after starting the medication. Which of the following recommendations should the nurse make?

The nurse should describe hyperactive bowel sounds as sounds that are loud, high-pitched, and increased in frequency and intensity. They are more frequent than the normal bowel sounds, with a rapid succession of sounds occurring at a rate greater than 5 to 30 sounds per minute.

Hyperactive bowel sounds can be heard in conditions such as gastroenteritis, diarrhea, and early mechanical bowel obstruction. They indicate increased bowel motility and are often associated with increased peristalsis.

To differentiate hyperactive bowel sounds from normal or hypoactive bowel sounds, the nurse can explain that hypoactive bowel sounds are decreased or absent sounds that occur when the bowel motility is decreased, such as in conditions like paralytic ileus or after abdominal surgery. Normal bowel sounds are typically soft, low-pitched, and occur at a rate of 5 to 30 sounds per minute.

Explanation

B. Wipe any excess medication from the inner canthus outward

Bacitracin ophthalmic ointment is an antibiotic medication commonly used to treat bacterial eye infections such as conjunctivitis.

Wiping any excess medication from the inner canthus outward, is important to prevent the accumulation of excessive ointment, which can cause discomfort and affect vision. Using a clean, sterile cotton ball or tissue, the nurse should gently wipe any excess ointment from the inner corner of the eye (inner canthus) and then move outward to remove the excess ointment.

Gently massaging the eyelid to facilitate absorption of the medication in (option A) is not recommended. It can potentially cause discomfort or further irritation to the affected eye, especially in a young child. The ointment will naturally spread across the eye as the child blinks.

Placing an occlusive dressing on the affected eye in (option C) is not necessary for the treatment of bacterial conjunctivitis. It may impede proper air circulation and potentially worsen the infection. It is important to promote hygiene and prevent the spread of infection by encouraging proper handwashing and avoiding touching or rubbing the affected eye.

Instructing the guardian to apply erythromycin ophthalmic ointment every morning for 14 days in (option D) is not appropriate in this case. Erythromycin is an alternative antibiotic commonly used for conjunctivitis, but since the child has been prescribed bacitracin ophthalmic ointment, the appropriate course of treatment would be to follow the prescribed medication as directed by the healthcare provider.