A nurse is preparing to assist with an ocular irrigation for a client who had a chemical splash to the left eye. Which of the following actions should the nurse plan to take?

Irrigate the affected eye from the inner corner toward the outer corner.

Sit the client up with their head turned toward the right side.

Place a strip of pH paper under the upper lid of the affected eye.

Irrigate the affected eye using sterile water.

Answer and Explanation

The Correct Answer is C

Choice A reason: Irrigating the affected eye from the inner corner toward the outer corner is the recommended method for ocular irrigation. This technique helps to flush out the chemical agent without risking further contamination to the other eye or nasal passages.

Choice B reason: Positioning the client sitting up with their head turned toward the right side is appropriate when irrigating the left eye. This position allows gravity to assist in the flow of the irrigation solution away from the unaffected eye, reducing the risk of cross-contamination.

Choice C reason: Placing a strip of pH paper under the upper lid of the affected eye is a critical step in ocular irrigation after a chemical splash. It is used to measure the pH of the ocular surface to ensure that the pH has normalized to a range between 7.0 and 7.2 after irrigation, indicating that the chemical has been adequately flushed out.

Choice D reason: Using sterile water for ocular irrigation is not recommended because it can cause osmotic imbalances and damage to the corneal cells. Instead, normal saline or balanced salt solutions are preferred as they are isotonic and more compatible with the physiological environment of the eye.

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Correct Answer is ["B","C","E"]

Explanation

Choice A reason:Frequent exposure to low-volume noise is not typically a risk factor for hearing loss. Hearing loss is more commonly associated with prolonged exposure to high-volume noise, which can damage the delicate structures within the ear.

Choice B reason: Chronic infections of the middle ear, such as chronic otitis media, can lead to hearing loss. These infections can cause persistent inflammation and fluid buildup, which may damage the middle ear structures over time, leading to conductive hearing loss.

Choice C reason: Perforation of the eardrum, or a ruptured eardrum, can result in hearing loss. The eardrum is essential for the proper conduction of sound waves to the inner ear. A perforation disrupts this process and can reduce hearing ability until the eardrum heals or is surgically repaired.

Choice D reason: Being born with a high birth weight is not a known risk factor for hearing loss. Hearing loss at birth is more commonly associated with genetic factors, prenatal and perinatal infections, and complications during birth.

Choice E reason: The use of a loop diuretic can be a risk factor for hearing loss. These medications can have ototoxic effects, especially when administered in high doses or with rapid intravenous infusion, potentially leading to temporary or permanent hearing loss.

A. Change the ostomy pouch daily. B. Empty the ostomy pouch when it is 2/3 full. C. Trim the opening of the ostomy seal to be 1/2 inch wider than the stoma. D. Apply lotion to the peristomal skin when changing the ostomy pouch.

Correct Answer is B

Explanation

Choice A reason: Changing the ostomy pouch daily is not necessary and could lead to skin irritation from the frequent removal and application of the adhesive. Ostomy pouches are designed to be worn for several days, and the schedule for changing them can vary based on the type of pouch and individual needs.

Choice B reason: Emptying the ostomy pouch when it is 2/3 full is the correct instruction. This prevents the pouch from becoming too heavy, which could pull on the stoma and cause discomfort or damage. It also reduces the risk of leaks and odors.

Choice C reason: Trimming the opening of the ostomy seal to be 1/2 inch wider than the stoma is incorrect. The opening should be trimmed to match the size of the stoma to provide a secure fit and prevent leakage of the contents onto the skin, which could cause irritation or infection.

Choice D reason: Applying lotion to the peristomal skin when changing the ostomy pouch is not recommended. Lotions or creams can interfere with the adhesive of the ostomy appliance and reduce the effectiveness of the seal. The peristomal skin should be clean and dry to ensure the best adherence of the ostomy appliance.

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A nurse is preparing to assist with an ocular irrigation for a client who had a chemical splash to the left eye. Which of the following actions should the nurse plan to take?

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