The nurse is preparing to administer ear drops to an adult client. Which of the following actions should the nurse plan to take?
Chill the otic solution prior to administration.
Pull the pinna upward and backward.
Avoid applying pressure to the tragus of the ear.
Don sterile gloves to instill the medication.
The Correct Answer is B
A) Chill the otic solution prior to administration:
Chilling ear drops is not typically necessary or recommended. Cold solutions can cause discomfort or dizziness when instilled into the ear. Room temperature or slightly warmed ear drops are generally more comfortable for the client.
B) Pull the pinna upward and backward:
This is the correct action for administering ear drops to an adult client. Pulling the pinna (outer ear) upward and backward helps straighten the ear canal, allowing the drops to enter the ear canal properly.
C) Avoid applying pressure to the tragus of the ear:
The tragus is the small cartilaginous flap in front of the ear canal. Applying pressure to the tragus can help facilitate the flow of medication into the ear canal rather than avoiding it. Gently pressing on the tragus after instilling the drops can aid in distributing the medication.
D) Don sterile gloves to instill the medication:
Sterile gloves are not typically required for administering ear drops unless the nurse is dealing with a client with a compromised immune system or open ear canal. Standard precautions (clean hands) are usually sufficient for administering ear drops.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["94"]
Explanation
To calculate the flow rate for the IV infusion, we can follow these steps:
Identify the total volume to be infused: The total volume of 0.9% sodium chloride (NaCl) solution is 750 mL.
Identify the infusion time: The nurse needs to administer the solution over 8 hours.
Calculate the flow rate: We need to find out how many milliliters (mL) per hour (hr) the IV pump should deliver.
Here's the formula:
Flow rate (mL/hr) = Total volume (mL) / Infusion time (hr)
Flow rate (mL/hr) = 750 mL / 8 hr
Flow rate = 93.75 mL/hr
Rounding the answer: Since we are dealing with medication administration, it's important to round to the nearest whole number to avoid inaccurate dosing. In this case, rounding down is appropriate.
Therefore, the nurse should set the IV pump to deliver 94 mL/hr.
Correct Answer is D
Explanation
A) Notify the nurse manager:
While it's important to communicate the error to the nurse manager and appropriate supervisors, the immediate priority is to address the client's current condition and ensure their safety.
B) Complete an incident report:
Filling out an incident report is necessary to document the error and ensure proper follow-up and investigation. However, the client's immediate well-being takes precedence.
C) Give the client 15 to 20 g of carbohydrate:
Administering carbohydrates may be necessary if the client is hypoglycemic, but checking the blood glucose level first is essential to confirm the current status and determine the appropriate intervention.
D) Check the client's blood glucose level:
This is the priority action because it allows the nurse to assess the client's current blood glucose level and determine if corrective action, such as administering carbohydrates or further insulin adjustments, is needed to address any potential hypoglycemia resulting from the incorrect insulin dose.
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