A nurse is reinforcing teaching with the parents of a preschool-age child who has a new diagnosis of celiac disease.

Which of the following foods should the nurse recommend?

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.

Restlessness is a common sign that a client's pain is not adequately relieved. When a client experience unrelieved pain, they may find it difficult to get comfortable and may exhibit restlessness, such as frequently changing positions, fidgeting, or appearing agitated. It is important for the nurse to assess the client's pain level and address any concerns regarding pain management.

While difficulty swallowing (dysphagia), constipation, and urinary retention can be potential side effects or complications associated with spinal epidural anesthesia, they are not specific indicators of unrelieved pain. These findings may be related to the effects of the anesthesia itself or other factors, and they should still be assessed and addressed by the nurse. However, restlessness is more directly linked to the experience of pain and should be recognized as an important sign that the client's pain relief measures may need adjustment.