A nurse is reviewing orders for a patient in anaphylactic shock. Which medication should the nurse plan to administer first?

Choice A reason: Ocular irrigation should be performed from the inner corner (near the nose) toward the outer corner to avoid contaminating the other eye and to ensure that the flushing fluid and any chemical residue flow away from the unaffected eye. This method helps to minimize the risk of spreading the chemical to the other eye and allows for a more effective removal of the chemical from the affected eye.

Choice B reason: While positioning the client upright is correct, having the head turned toward the right side is not specifically recommended. The client should be positioned in a way that facilitates the flow of the irrigation fluid away from the unaffected eye, which typically means tilting the head to the side of the affected eye.

Choice C reason: Placing a strip of pH paper under the upper lid of the affected eye is done to measure the pH of the tear film and determine the acidity or alkalinity of the chemical involved. However, this is not an immediate action during the initial irrigation process. The first priority is to dilute and remove the chemical from the eye as quickly as possible.

Choice D reason: While sterile water can be used for ocular irrigation, it is not the first choice. The preferred solution for ocular irrigation is a saline solution or specific eye irrigating solutions because they are isotonic and less irritating to the eye tissues. Sterile water may cause discomfort due to its hypotonicity, which can lead to cellular swelling.

Choice A reason: While bladder control issues can significantly affect a client's quality of life, they are typically managed by a urologist or a specialist in continence, rather than an occupational therapist. Occupational therapy focuses on improving the ability to perform activities of daily living (ADLs), which generally does not include bladder control.

Choice B reason: Difficulty swallowing, known as dysphagia, can be a symptom of myasthenia gravis due to muscle weakness. Although it is a serious concern, it is usually managed with the help of a speech therapist who specializes in swallowing difficulties, rather than an occupational therapist.

Choice C reason: Having a hard time with brushing hair is directly related to the performance of ADLs, which is the primary focus of occupational therapy. An occupational therapist can assist the client by teaching energy conservation techniques, providing adaptive equipment, and modifying the task to make it easier for the client to maintain personal grooming independently.

Choice D reason: Preferring a wheelchair over a walker is a matter of mobility and personal preference. While occupational therapy can help with mobility issues, this statement alone does not indicate a need for occupational therapy unless the client has difficulty performing ADLs due to the choice of mobility aid.