A nurse is preparing to administer timolol eye drops to a client who has glaucoma. In which order should the nurse perform the following steps? (place the steps , placing them in the order of performance.)
Verify the clarity and color of the eye drops.
Tilt the client's head backward toward the ceiling.
Pull the client's lower lid down with the nondominant hand.
Administer the prescribed number of drops.
Apply gentle pressure to the client's punctum.
Administer the prescribed number of drops
Apply gentle pressure to the client's punctum
Tilt the client's head backward toward the ceiling
Pull the client's lower lid down with the nondominant hand
Verify the clarity and color of the eye drops
The Correct Answer is E,C,D,A,B
- Verify the clarity and color of the eye drops. Ensuring the medication is not expired or contaminated is the first step in safe administration.
- Tilt the client's head backward toward the ceiling. This position helps prevent the drops from draining out of the eye.
- Pull the client's lower lid down with the nondominant hand. This creates a small pocket for the eye drops to be instilled properly.
- Administer the prescribed number of drops. The medication should be placed in the conjunctival sac, not directly on the cornea.
- Apply gentle pressure to the client's punctum. This prevents systemic absorption by blocking the nasolacrimal duct and reduces systemic side effects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "Store unused patches in the refrigerator." Scopolamine patches should be stored at room temperature, not in the refrigerator.
B. "Apply the patch prior to traveling." The patch should be applied at least four hours before travel to allow time for absorption and effectiveness.
C. "Place the patch on your upper arm." The patch should be applied behind the ear, not on the upper arm, for optimal absorption.
D. "Replace a dislodged patch onto the same location." A new patch should be applied to a different area to prevent skin irritation.
Correct Answer is B
Explanation
A. Obtain a tympanogram reading prior to initiating the test. This is incorrect because a tympanogram assesses middle ear function and is not part of the Weber test, which evaluates hearing loss type.
B. Place a vibrating tuning fork on the top of the child's head. This is correct because the Weber test involves placing a vibrating tuning fork on the midline of the skull to determine if sound is heard equally in both ears, helping to differentiate between conductive and sensorineural hearing loss.
C. Hold a vibrating tuning fork 1 to 2 cm (0.4 to 0.8 in) from the child's ears. This is incorrect because this describes the Rinne test, which compares air conduction to bone conduction.
D. Measure the amount of time the child can hear the sound. This is incorrect because the Weber test does not measure duration but assesses lateralization of sound perception.
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