Question 1

Which is a potential serious adverse effect associated with mannitol (Osmitrol)?

Accepted Answer

Mannitol is a diuretic medication used to treat cerebral edema, but it can cause fluid overload, which is a potentially serious adverse effect. Bradycardia, anaphylaxis, and fever are not commonly associated with mannitol.

Question 2

Which information will the nurse include when teaching the patient and family about postoperative care for a trabeculectomy? (Select all that apply.)

Accepted Answer

A, C, D, E

Question 3

What is the mechanism of action of osmotic agents when used to decrease IOP?

Accepted Answer

Osmotic agents work by increasing plasma osmolarity, which draws fluid from the vitreous body of the eye into the bloodstream, thereby reducing intraocular pressure (IOP).

Question 4

Which statement is true about aqueous humor? (Select all that apply.)

Accepted Answer

Aqueous humor is a clear, watery fluid that fills the space between the cornea and the lens. It helps to maintain the shape of the eye and provides nutrients to the cornea, lens, and iris. It also helps to remove waste products from these structures. Aqueous humor drains out of the eye through drainage channels called the trabecular meshwork and Schlemm's canal located near the junction of the cornea and sclera. It then flows out of the canal of Schlemm into the venous system of the eye. Therefore, statements A, C, and E are all true about aqueous humor. Statement B is not true as the iris color is determined by pigments and not by aqueous humor. Statement D is also not true as the lacrimal gland and accessory lacrimal glands are responsible for tear production.

Question 5

Which are important teaching points for the nurse to review with a patient recently diagnosed with open-angle glaucoma? (Select all that apply.)

Accepted Answer

It is important for the nurse to review with the patient that open-angle glaucoma can cause damage to the optic disc if left untreated, and that the loss of peripheral vision is a common trigger for diagnosis. Additionally, the nurse should emphasize that total blindness may result if the glaucoma is not treated. It is important to dispel the myth that glaucoma is not a serious disease and that treatment is only necessary when symptoms are bothersome. It is not necessary to mention symptoms as sudden and painful because open-angle glaucoma is typically asymptomatic in its early stages.

Question 6

Which medication is used to produce miosis following a diagnostic procedure?

Accepted Answer

Pilocarpine is used to produce miosis (constriction of the pupil) and is commonly used following a diagnostic procedure such as a tonometry test. Mannitol is an osmotic diuretic used to reduce cerebral edema, Atropine is used for mydriasis (dilation of the pupil) and to treat bradycardia, and Epinephrine is used to treat severe allergic reactions and to increase blood pressure.

Question 7

Which type of medication would be used to dilate the pupils before an eye examination?

Accepted Answer

An adrenergic agent such as phenylephrine is commonly used to dilate the pupils before an eye examination. Osmotics (A) are used to decrease intraocular pressure, beta-adrenergic agents (C) are used to treat glaucoma or hypertension, and corticosteroids (D) are used to treat inflammation.

Question 8

What is the action of timolol maleate (Timoptic), a beta-adrenergic blocking agent?

Accepted Answer

Timolol maleate (Timoptic) is a beta-adrenergic blocking agent that decreases the production of aqueous humor. This action reduces intraocular pressure and is used to treat conditions such as glaucoma.

Question 9

A patient recently diagnosed with glaucoma is to begin drug therapy with carbonic anhydrase inhibitors. About which assessment would the nurse need to contact the health care provider? (Select all that apply.)

Accepted Answer

Carbonic anhydrase inhibitors can cause electrolyte imbalances and are contraindicated in patients with a history of sulfonamide allergy.

Question 10

The nurse is preparing a patient for an ophthalmic examination. Which action occurs when the nurse instills eye drops to produce mydriasis?

Accepted Answer

Instilling eye drops to produce mydriasis results in extreme dilation of the pupil, allowing for a better view of the internal structures of the eye during an ophthalmic examination. It does not cause drying of tears in the eyes, opening of the canal of Schlemm, or paralysis of the ciliary muscle.

Question 11

Which information will the nurse include when instructing a patient on the correct method of instilling eye drops? (Select all that apply.)

Accepted Answer

The nurse should instruct the patient to use a separate source of medication and droppers for each eye to prevent cross-contamination in case of infection. The patient should also wash hands before and after administration to prevent the spread of infection. The lids of the medication container and the surface area where the medication is placed should be kept clean to avoid contamination. The patient should be instructed never to touch the tip of the dropper or opening of the ointment container to prevent contamination. However, the instruction to wipe the eye from the outer to inner canthus is not necessary for correctly administering eye drops.

Question 12

A factory worker had a chemical inadvertently splashed into his right eye. An eyewash was used at the work site. Which nursing assessments are important to include? (Select all that apply.)

Accepted Answer

Visual acuity is important to assess any changes in vision. Assessing for pain, blurred vision, or lack of vision helps determine the extent of injury. Knowing the type of chemical is crucial for appropriate treatment. Checking for contacts or eyeglasses is important as they may need to be removed or could have been affected by the chemical. Nystagmus is not typically related to chemical exposure.

Question 13

Which discharge instruction will the nurse include for a patient sent home from the clinic who is taking an adrenergic ophthalmic solution for an acute inflammation?

Accepted Answer

The answer of Which discharge instruction will the nurse include...

Question 14

What is the purpose of administering a cycloplegic agent? (Select all that apply.)

Accepted Answer

A cycloplegic agent is used to facilitate examination of the eye by paralyzing the ciliary muscle, which helps to relax the eye and prevent accommodation. This is helpful during eye exams in order to get an accurate measurement of refractive error. It can also facilitate surgery on the eye by relaxing the eye muscles and preventing involuntary eye movement during the procedure. Pupillary dilation is a side effect of cycloplegic agents, but not necessarily the intended purpose. Decreasing the production of aqueous humor is not a function of cycloplegic agents.

Quiz 43: Drugs Used to Treat Glaucoma and Other Eye Disorders

Which is a potential serious adverse effect associated with mannitol (Osmitrol) ?