Question

Difficulty: EasyPharmacological Therapies

An adult client who was recently diagnosed with bacterial conjunctivitis is prescribed ciprofloxacin ophthalmic solution. The practical nurse enters the client's room to instill the medication. In which order should the nurse perform the following actions? Arrange the steps in the correct chronological sequence from first to last.

  1. 1Perform hand hygiene and put on a pair of clean gloves.
  2. 2Ask the client to tilt their head backward and look up at the ceiling.
  3. 3Gently pull the client's lower eyelid downward to expose the conjunctival sac.
  4. 4Squeeze the prescribed number of drops directly into the conjunctival sac.
  5. 5Apply gentle pressure to the inner canthus of the eye for 1 to 2 minutes.

Answer

The correct sequence for administering ophthalmic drops is: Perform hand hygiene and put on gloves, position the client's head backward, expose the conjunctival sac by pulling the lower eyelid down, instill the drops into the sac, and finally apply pressure to the inner canthus.
Administering eye drops requires a strict aseptic technique and specific steps to ensure localized medication delivery. First, the nurse must perform hand hygiene and don gloves to prevent infection. Next, positioning the client with the head tilted back and eyes looking upward minimizes the blink reflex. The nurse then pulls the lower eyelid down to expose the conjunctival sac, which is the proper anatomical location for receiving drops. After instilling the drops into the sac, applying gentle pressure to the inner canthus prevents the medication from flowing into the tear duct, thereby avoiding unwanted systemic absorption.

Step-by-Step Solution

1
Perform hand hygiene and don clean gloves.
Infection control measures are established before contact.
The eye is highly susceptible to infection, making hand hygiene the critical first action.
2
Position the client by having them tilt their head back and look upward.
The client is in the optimal position for administration.
Looking up and tilting the head back moves the cornea away from the lower lid and reduces the natural blink reflex.
3
Pull the lower eyelid down to reveal the conjunctival sac.
A small pocket is created for the medication.
Drops should never be placed directly on the cornea because it can cause trauma and discomfort.
4
Instill the drops into the conjunctival sac.
The medication is safely and accurately delivered.
Dropping the medication into the sac ensures proper distribution across the eye surface when the client gently closes their eye.
5
Apply pressure to the inner canthus (nasolacrimal duct).
Systemic absorption of the eye drops is prevented.
Occluding the nasolacrimal duct keeps the medication localized to the eye and prevents it from entering the systemic circulation.

Key Concept

Safe Administration of Ophthalmic Medications
Estimated Time:1m 0s
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