A nurse is reinforcing teaching with a client with bacterial conjunctivitis of the right eye, and a prescription for an antibiotic ophthalmic ointment. Which of the following statements should the nurse make?

"Apply the ointment in a thin line into the conjunctival sac."

"Keep your eye open for 30 sec after instilling the ointment."

"Use a sterile glove and applicator to apply the antibiotic ointment."

"Always wipe from the outer to the inner canthus when wiping away secretions."

Answer and Explanation

The Correct Answer is A

A) "Apply the ointment in a thin line into the conjunctival sac":
This instruction is correct for applying ophthalmic ointments. Placing the ointment in a thin line along the conjunctival sac ensures proper distribution and contact with the affected area.

B) "Keep your eye open for 30 sec after instilling the ointment":
Keeping the eye open for a brief period after instillation helps the ointment spread across the eye surface. This statement indicates understanding of the proper technique for applying ophthalmic ointments and does not require further instruction.

C) "Use a sterile glove and applicator to apply the antibiotic ointment":
Using a sterile glove and applicator ensures that the application is done in a sterile manner, reducing the risk of introducing further infection. This statement indicates a need for further instruction, as ophthalmic ointments are typically applied using clean hands or disposable, sterile applicators rather than sterile gloves.

D) "Always wipe from the outer to the inner canthus when wiping away secretions":
Wiping from the outer to the inner canthus helps prevent contamination of the unaffected eye. This statement demonstrates understanding of proper eye care techniques and does not require further instruction.

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Correct Answer is D

Explanation

A) A client taking a potassium supplement twice a day:
Taking potassium supplements can actually lower the risk of digoxin toxicity because hypokalemia (low potassium levels) increases the risk of digoxin toxicity. Potassium supplements help maintain adequate potassium levels, which is beneficial for clients taking digoxin.

B) A client taking aluminum hydroxide for gastric upset:
Aluminum hydroxide can bind to digoxin in the gastrointestinal tract, reducing its absorption. This interaction can decrease the effectiveness of digoxin rather than increase the risk of toxicity.

C) A client taking chlorpropamide for type 2 diabetes mellitus:
Chlorpropamide does not interact significantly with digoxin or affect electrolyte levels in a way that would increase the risk of digoxin toxicity.

D) A client taking furosemide for chronic hypertension:
Furosemide, a loop diuretic, can cause hypokalemia and hypomagnesemia, which are risk factors for digoxin toxicity. Low potassium levels enhance the toxicity of digoxin by increasing its binding to cardiac tissue receptors, leading to enhanced cardiac effects.

A. Serum calcium 10.5 mg/dL B. Serum potassium 5.2. C. Serum chloride 99 mEq/L D. Serum sodium 140 mEq/L

Correct Answer is B

Explanation

A) Serum calcium 10.5 mg/dL:
A serum calcium level of 10.5 mg/dL is within the normal range (8.5-10.5 mg/dL). Spironolactone does not typically affect calcium levels significantly.

B) Serum potassium 5.2 mEq/L:
An elevated serum potassium level (hyperkalemia) is a known adverse effect of spironolactone. Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, leading to decreased potassium excretion and potential hyperkalemia, especially in clients with impaired renal function.

C) Serum chloride 99 mEq/L:
A serum chloride level of 99 mEq/L is within the normal range (96-106 mEq/L). Spironolactone does not typically affect chloride levels significantly.

D) Serum sodium 140 mEq/L:
A serum sodium level of 140 mEq/L is within the normal range (135-145 mEq/L). Spironolactone does not typically affect sodium levels significantly.

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A nurse is reinforcing teaching with a client with bacterial conjunctivitis of the right eye, and a prescription for an antibiotic ophthalmic ointment. Which of the following statements should the nurse make?

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