The nurse is applying erythromycin ointment to the lower lid of the newborn’s eyes. What is the purpose of this medication for the newborn?
To provide moisture
To prevent chemical conjunctivitis
To prevent infection
To treat infection
The Correct Answer is C
Choice A rationale:
Erythromycin ointment does not have moisturizing properties. Its primary function is to act as an antibiotic to prevent bacterial infections.
While it may have a slightly lubricating effect due to its ointment base, this is not its intended purpose.
If moisture is the primary goal, artificial tears or other ophthalmic lubricants would be more appropriate choices.
Choice B rationale:
Chemical conjunctivitis is typically caused by irritants such as chlorine, smoke, or chemicals, not bacteria. Erythromycin is not effective in preventing or treating chemical conjunctivitis.
Treatment for chemical conjunctivitis usually involves flushing the eyes with saline or water and applying cool compresses, as well as potentially using topical antihistamines or corticosteroids to reduce inflammation.
Choice D rationale:
Erythromycin ointment is not typically used to treat active eye infections in newborns.
While it can be used for this purpose in certain cases, it is more commonly used as a prophylactic measure to prevent infections from developing in the first place.
If a newborn has a suspected eye infection, a healthcare provider would likely collect a sample of discharge for testing and culture to determine the specific causative organism and select the most appropriate antibiotic treatment.
Choice C rationale:
The primary purpose of applying erythromycin ointment to a newborn's eyes is to prevent bacterial eye infections, specifically ophthalmia neonatorum.
Ophthalmia neonatorum is a serious condition that can lead to vision loss if not treated promptly.
It is most commonly caused by the bacteria Neisseria gonorrhoeae and Chlamydia trachomatis, which can be transmitted to the newborn during childbirth if the mother is infected.
Erythromycin ointment is effective in preventing these infections by killing or inhibiting the growth of these bacteria. It is typically applied to the newborn's eyes within 1 hour of birth as a standard practice in many countries.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Norepinephrine is a potent vasoconstrictor, meaning it narrows blood vessels. It primarily acts on arteries, but it can also constrict veins to a lesser extent.
Its primary actions are to increase systemic vascular resistance and blood pressure.
It is often used in conditions such as shock to raise blood pressure and improve perfusion to vital organs.
It is not a vasodilator and would not be appropriate for a patient requiring dilation of both arteries and veins.
Choice B rationale:
Nitroglycerin is a vasodilator that primarily acts on veins. It relaxes the smooth muscle in the walls of veins, which allows them to dilate and hold more blood.
This reduces the amount of blood returning to the heart, which in turn lowers preload and reduces cardiac workload.
Nitroglycerin is often used to treat angina pectoris, a condition characterized by chest pain due to insufficient blood flow to the heart.
While it can also have some vasodilatory effects on arteries, its primary action is on veins.
Choice C rationale:
Nitroprusside sodium (Nitropress) is a potent vasodilator that acts on both arteries and veins. It directly relaxes smooth muscle in the blood vessel walls, leading to dilation.
It is a very powerful vasodilator and can rapidly lower blood pressure.
It is often used in hypertensive emergencies to quickly reduce blood pressure and improve cardiac function.
It is also used in conditions such as congestive heart failure and acute aortic dissection to reduce afterload and improve cardiac output.
Choice D rationale:
Lidocaine is a local anesthetic agent that is primarily used to block nerve conduction. It does not have any direct vasodilatory effects.
It is sometimes used in the treatment of cardiac arrhythmias, but its mechanism of action in this setting is not related to vasodilation.
Correct Answer is B
Explanation
Choice A rationale:
Dopamine was once considered a first-line vasopressor for cardiogenic shock. However, recent studies have shown that it is associated with increased mortality compared to norepinephrine.
Dopamine has dose-dependent effects on dopamine receptors, beta receptors, and alpha receptors. At low doses (1-5 mcg/kg/min), it primarily stimulates dopamine receptors, leading to renal vasodilation and increased urine output. At moderate doses (5-10 mcg/kg/min), it stimulates beta receptors, resulting in increased heart rate and contractility. At high doses (>10 mcg/kg/min), it stimulates alpha receptors, causing vasoconstriction.
The main concern with dopamine is its potential to cause arrhythmias, particularly at higher doses. This is due to its effects on beta receptors, which can increase heart rate and myocardial oxygen demand.
Additionally, dopamine can cause tachyphylaxis, meaning that its effects can diminish over time, requiring higher doses to achieve the same effect.
Choice B rationale:
Norepinephrine is a potent alpha-adrenergic agonist that causes vasoconstriction, leading to an increase in blood pressure. It has minimal effects on beta receptors, so it is less likely to cause tachycardia and arrhythmias compared to dopamine.
Norepinephrine also has some inotropic effects, meaning that it can increase the strength of contraction of the heart muscle.
Studies have shown that norepinephrine is associated with improved survival rates in patients with cardiogenic shock compared to dopamine.
It is generally well-tolerated, with the most common side effects being hypertension and peripheral vasoconstriction.
Choice C rationale:
Epinephrine is a potent alpha- and beta-adrenergic agonist that causes vasoconstriction, increased heart rate, and increased contractility.
It is typically used as a second-line agent in cardiogenic shock, after norepinephrine has failed to achieve adequate blood pressure.
Epinephrine can cause significant tachycardia and arrhythmias, so it should be used with caution in patients with underlying heart disease.
Choice D rationale:
Vasopressin is a hormone that causes vasoconstriction by acting on V1 receptors in vascular smooth muscle. It is sometimes used as an adjunct to norepinephrine in patients with refractory cardiogenic shock.
Vasopressin has the potential to cause coronary vasoconstriction, so it should be used with caution in patients with coronary artery disease.
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