A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.)

A) Enteral:
Enteral routes, such as oral or rectal, involve absorption through the gastrointestinal tract. This process generally takes longer due to factors such as digestion and metabolism in the liver before reaching systemic circulation.

B) Intramuscular:
Intramuscular injections are absorbed faster than subcutaneous injections but slower than intravenous administration. The absorption rate can be influenced by factors such as blood flow to the muscle and the drug's formulation.

C) Intravenous:
The intravenous (IV) route provides the fastest rate of absorption because the medication is delivered directly into the bloodstream, bypassing absorption barriers and ensuring immediate availability for systemic effect. This route is often used for emergency situations and precise dosing.

D) Topical:
Topical administration involves applying medication directly to the skin or mucous membranes. This route has a slower rate of absorption compared to intravenous administration due to the need for the medication to pass through the skin or mucosal barriers before entering systemic circulation.

A) Apply pressure to the client's nasolacrimal duct after instillation:
Applying gentle pressure to the nasolacrimal duct (located at the inner corner of the eye) after administering ophthalmic medication helps to reduce systemic absorption and increase the medication’s efficacy. This technique helps to prevent the medication from draining into the nasolacrimal duct and into the systemic circulation.

B) Clean the client's eye from the outer canthus to the inner canthus before instillation:
The eye should be cleaned from the inner canthus to the outer canthus to avoid transferring debris or infection from the outer parts of the eye to the inner areas. Cleaning from outer to inner canthus may cause contamination.

C) Ask the client to tightly squeeze their eyes shut after the instillation:
Asking the client to tightly squeeze their eyes shut is not recommended as it can cause the medication to be expelled or lead to increased systemic absorption. Instead, the client should gently close their eyes to allow for proper absorption.

D) Instill the ophthalmic medication directly on the client's cornea:
The medication should be administered into the conjunctival sac rather than directly on the cornea. Direct application to the cornea can cause irritation or damage.