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 A
Explanation
A) Trazolam orally at bedtime:
Trazolam is a benzodiazepine used for insomnia and can cause daytime sedation. Clients should avoid hazardous activities, such as driving, while taking this medication due to the potential for impaired alertness and coordination.
B) Polyethylene glycol dissolved in 240 ml of water once daily:
Polyethylene glycol is a laxative used for bowel cleansing and maintenance. It does not typically cause daytime sedation or impair cognitive function, so avoiding hazardous activities is not necessary.
C) Adalimumab subcutaneously every 2 weeks:
Adalimumab is a biologic medication used to treat inflammatory conditions like rheumatoid arthritis and does not typically cause sedation or impair cognitive function.
D) Ketoconazole orally once daily with food:
Ketoconazole is an antifungal medication that does not cause significant sedation or impair cognitive function. Hazardous activities are not typically restricted while taking this medication.
Correct Answer is ["25"]
Explanation
Calculating IV Drip Rate for Manual Infusion
Here's how to calculate the drip rate for the manual IV infusion:
Identify total volume and infusion time:
Total volume of saline solution (NS) to infuse: 100 mL
Infusion time: 4 hours
Convert infusion time to minutes:
4 hours x 60 minutes/hour = 240 minutes
Determine the drip factor:
Drip factor: 60 gtt/mL (indicates the number of drops delivered per milliliter of solution by the IV tubing)
Calculate the desired flow rate (mL/min):
We want to know how many milliliters the nurse needs to infuse per minute.However, the question asks for the rate in gtt/min. We'll calculate the mL/min rate first and then convert it to gtt/min.
Flow rate (mL/min) = Total volume (mL) / Infusion time (minutes)
Flow rate (mL/min) = 100 mL / 240 minutes
Flow rate (mL/min) = 0.4167 mL/min (round to four decimal places for accurate conversion)
Convert mL/min to gtt/min:
Flow rate (gtt/min) = Flow rate (mL/min) x Drip factor (gtt/mL)
Flow rate (gtt/min) = 0.4167 mL/min x 60 gtt/mL
Flow rate (gtt/min) = 25 gtt/min (round to nearest whole number)
Therefore, the nurse should set the manual IV infusion to deliver approximately 25 gtt/min.
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