A nurse is teaching a client who has a new prescription for tetracycline.
Which of the following information should the nurse include in the teaching?

Choice A rationale

Verifying the clarity and color of the eye drops is a critical safety step to ensure the medication has not been compromised. Eye drops should be clear and colorless unless specified otherwise. Any discoloration or particulate matter indicates that the solution may be contaminated or expired and should not be administered, preventing potential harm or infection to the client.

Choice B rationale

Pulling the lower lid down creates a small pocket, or conjunctival sac, which is the proper site for medication administration. This technique prevents the eye drops from immediately flowing out of the eye, allowing for maximum absorption of the medication. It also protects the cornea from direct injury by the applicator, which can be sensitive and easily scratched.

Choice C rationale

Applying gentle pressure to the punctum, the small opening in the corner of the eye, for 30 to 60 seconds after instillation prevents systemic absorption of the medication. This is particularly important for drugs like timolol, a beta-blocker, as systemic absorption can lead to adverse effects on the heart and lungs, such as bradycardia and bronchospasm.

Choice D rationale

Tilting the client's head backward facilitates proper administration by allowing gravity to assist in directing the eye drop into the conjunctival sac. This position also helps to prevent the drop from immediately rolling out of the eye or onto the client's cheek, ensuring the medication is retained in the correct location for therapeutic effect.

Choice E rationale

Administering the prescribed number of drops directly into the conjunctival sac ensures the client receives the correct dosage. The nurse should avoid touching the tip of the dropper to the client's eye or eyelashes to prevent cross-contamination of the bottle. This step is essential for both the therapeutic efficacy and safety of the medication administration. *.

Choice A rationale

Tetracycline binds to divalent and trivalent cations such as calcium, magnesium, and aluminum. Milk and dairy products are rich in calcium, so taking tetracycline with milk significantly reduces its absorption from the gastrointestinal tract, rendering the medication less effective. The drug should be taken on an empty stomach with a full glass of water.

Choice B rationale

Taking tetracycline at bedtime is not a recommended practice for this drug. Although some medications are taken at night to avoid side effects or promote sleep, tetracycline can cause gastroesophageal reflux or esophagitis, particularly when a person lies down soon after ingestion. It is important to remain upright for at least 30 minutes after taking the medication.

Choice C rationale

Photosensitivity is a well-documented adverse effect of tetracycline. The drug sensitizes the skin to ultraviolet light, leading to an exaggerated sunburn reaction. This is due to the drug's accumulation in the skin and its ability to absorb light energy. Clients must be advised to use sunscreen, wear protective clothing, and avoid prolonged sun exposure.

Choice D rationale

Tetracycline is known to cause gastrointestinal side effects, but diarrhea is far more common than constipation. This is often due to the disruption of the normal gut flora, which can lead to opportunistic infections like Clostridium difficile. While not exclusively causing diarrhea, constipation is not a typical adverse effect and should not be the primary teaching point. *.