Question 1

A patient has a new prescription for an antiglaucoma eyedrop. The next day, she calls the clinic and states, "The package insert says this medication might make my blue eyes turn brown! Is this true?" The nurse realizes that the patient has a prescription for which eye medication?

Accepted Answer

There is one unique adverse effect associated with all prostaglandin agonists-in some people with hazel, green, or bluish-brown eye color, eye color will turn permanently brown, even if the medication is discontinued. This adverse effect appears to be cosmetic only, with no known ill effects on the eye. The other medications do not have this effect.

Question 2

The nurse is reviewing the use of ophthalmic preparations. Indications for the direct- and indirect-acting miotics include which condition?

Accepted Answer

Indications for the direct- and indirect-acting miotics include open-angle glaucoma, angle-closure glaucoma, ocular surgery, and convergent strabismus.

Question 3

A patient will be receiving mannitol (Osmitrol), 1.5 g/kg IV 1 hour before ocular surgery. The patient weighs 110 pounds. The medication is available as a 25% solution. Based on this patient's dose, calculate how many milliliters of mannitol this patient will receive, using the 25% solution.

Accepted Answer

300 mL
Convert the patient's weight to kilograms: 110 lbs ¸ 2.2 = 50 kg
Calculate the dose of mannitol: 50 kg × 1.5 g/kg = 75 g of mannitol
Using the 25% solution, which contains 25 g of mannitol in 100 mL of solution, calculate the milliliters needed:
25 g : 100 mL :: 75 g : x mL
(25 × x) = (100 × 75); 25x = 7500; x = 300 mL of the 25% mannitol solution

Question 4

A patient with an eye injury requires an ocular examination to detect the presence of a foreign body. The nurse anticipates that which drug will be used for this examination?

Accepted Answer

Fluorescein sodium is an ophthalmic diagnostic dye used to identify corneal defects and to locate foreign objects in the eye. Phenylephrine is an ocular decongestant; atropine sulfate has mydriatic and cycloplegic effects, which are useful for examining the inner eye structures; olopatadine is an ophthalmic antihistamine.

Question 5

The nurse is administering dipivefrin (Propine) eyedrops to a patient who has just started therapy with these drops. What potential systemic effect will the nurse monitor the patient for after this medication is given?

Accepted Answer

Although systemic effects associated with the use of sympathomimetic mydriatics such as dipivefrin are uncommon, they are theoretically possible, especially with the use of larger doses or prolonged drug therapy. They include cardiovascular effects, such as extrasystoles, tachycardia, and hypertension. Other effects that may be noticed are headache and faintness. Hypotension, bradycardia, and chest pain are not systemic effects of these drugs.

Question 6

The nurse will be giving ophthalmic drugs to a patient with glaucoma. Which drug is used to reduce intraocular pressure?

Accepted Answer

Drugs used to reduce intraocular pressure include osmotic diuretics such as mannitol. Tobramycin and bacitracin are antibiotics; ketorolac has antiinflammatory actions.

Question 7

A patient is about to undergo ocular surgery. The preoperative nurse anticipates that which drug will be used for local anesthesia?

Accepted Answer

Proparacaine (Alcaine) and tetracaine are used as a local anesthetic for ocular surgery or other procedures. The other drugs are used for glaucoma.

Question 8

A patient has been taking the corticosteroid dexamethasone (Decadron) but has developed bacterial conjunctivitis and has a prescription for gentamicin (Garamycin) ointment. The nurse notes that which interaction is possible if the two drugs are used together?

Accepted Answer

Concurrent use of corticosteroids, such as dexamethasone and ophthalmic antimicrobials, may cause immunosuppression that may make it more difficult to eliminate the eye infection.

Question 9

When teaching a patient about the proper application of timolol ( Timoptic ) eyedrops, the nurse will include which instruction?

Accepted Answer

All ophthalmic drugs should be administered in the conjunctival sac. Gently use a tissue to remove excess eye medication-do not blot the eye after giving the medication. Tilt the head back before giving the eyedrops.

Question 10

A patient is receiving ocular cyclosporine (Restasis) and also has an order for an artificial tears product. The nurse includes which instructions in the teaching plan for these medications?

Accepted Answer

Restasis can be used together with artificial tears if the drugs are given 15 minutes apart. The other options are incorrect.

Question 11

The nurse is administering ophthalmic drops. Place the following administration steps in the correct order.
A) Close the eye gently.
B) Apply gentle pressure to the inner canthus/lacrimal sac for 1 minute.
C) Place drops into the conjunctival sac.
D) Clean debris from the eye as needed.
E) Have the patient tilt the head back and look up at the ceiling.
F) Remove excess medication gently from around the eyes.

Accepted Answer

The answer of The nurse is administering ophthalmic drops. Place...

Question 12

The nurse is reviewing the medical record of a patient and notes an order for ophthalmic dexamethasone (Decadron) solution. The nurse knows that indications for ophthalmic dexamethasone include which conditions? (Select all that apply.)

Accepted Answer

Dexamethasone (Decadron) is used to treat inflammation of the eye, eyelids, conjunctiva, and cornea, and it may also be used in the treatment of uveitis, iridocyclitis, allergic conditions, and burns and in the removal of foreign bodies. It is not indicated for infections or glaucoma.

Question 13

The nurse is administering antibiotic eyedrops to a patient for the first time. After the first drop is given, the patient states, "That eyedrop is making my eye sting! Is that normal?" Which is the best response by the nurse?

Accepted Answer

Ocular antibiotics may cause local inflammation, burning, stinging, urticaria, and dermatitis. These effects are trAnswerient. The other options are incorrect.

Quiz 57: Ophthalmic Drugs