A nurse is caring for an adolescent who has an allergy to penicillin. Which of the following prescriptions should the nurse clarify with the provider?

b. Monitor the client for 15 min after meals.

d. Reinforce teaching about healthy eating during meals.

Explanation:

The correct answers are b. Monitor the client for 15 min after meals and d. Reinforce teaching about healthy eating during meals.

When planning care for a client with anorexia nervosa, it is important to focus on interventions that promote safety, nutritional rehabilitation, and psychological support.

Option a, encouraging the client to gain 2.3 kg (5 lb) per week, is not a realistic or healthy goal for weight gain in the context of anorexia nervosa. Rapid weight gain can be physically and psychologically overwhelming for the client and may reinforce disordered eating behaviors. Therefore, it is not an appropriate intervention.

Option c, weighing the client each morning after voiding, may contribute to obsessive monitoring of weight, which is a common feature of anorexia nervosa. Frequent weigh-ins can exacerbate anxiety and fixation on numbers, which are detrimental to the client's recovery. Therefore, it is not an appropriate intervention.

Option b, monitoring the client for 15 minutes after meals, is an important intervention. After meals, individuals with anorexia nervosa may engage in compensatory behaviors such as purging or excessive exercise. Monitoring the client for 15 minutes after meals allows for immediate identification of any concerning behaviors and provides an opportunity for therapeutic intervention, support, and redirection.

Option d, reinforcing teaching about healthy eating during meals, is also an important intervention. Although individuals with anorexia nervosa have distorted thoughts and beliefs related to food, providing education and support during meals can help them develop a healthier relationship with food and challenge their disordered eating behaviors and beliefs.

By recommending the interventions to monitor the client for 15 minutes after meals and reinforce teaching about healthy eating during meals, the nurse addresses the immediate post-meal period, promotes safety, provides support, and assists the client in their recovery journey. These interventions help ensure that the client is receiving appropriate care and support during meal times, which are critical for nutritional rehabilitation and challenging disordered eating behaviors.

Answer: A. Apply light pressure to the inner canthus just after instilling the eye drops.

Rationale:

A) Apply light pressure to the inner canthus just after instilling the eye drops.
Applying pressure to the inner canthus (the corner of the eye nearest the nose) helps occlude the nasolacrimal duct. This action reduces the systemic absorption of the medication by preventing it from draining into the nasal passages and subsequently into the systemic circulation, thus enhancing the local effect of the eye drops.

B) Wipe the eye from the inner to the outer canthus with a sterile saline-moistened cotton ball.
While this action may help remove excess medication or discharge, it does not minimize systemic absorption. Instead, wiping the eye could inadvertently spread the medication to other areas, increasing the chance of absorption rather than reducing it.

C) Administer the medication drops directly into the lower conjunctival sac of each eye.
While placing drops in the lower conjunctival sac is a standard practice for delivering ophthalmic medications, it does not directly influence systemic absorption. The main goal is to ensure adequate dosing in the eye, but systemic absorption can still occur if the drops drain into the nasolacrimal duct.

D) Wait 5 min after instillation before instilling the drops in the other eye.
Waiting between instillations is good practice to prevent dilution of the first dose and to allow for absorption. However, this action does not significantly impact systemic absorption. It focuses more on ensuring that the first dose is effective before administering a second dose.