A practical nurse is assigned to care for a client who has bacterial conjunctivitis and a history of open-angle glaucoma. The provider has prescribed timolol maleate ophthalmic solution (drops) and erythromycin ophthalmic ointment for the right eye. In which order should the nurse perform the following actions to safely administer these medications? Arrange the steps in the correct chronological sequence.
- 1Cleanse the client's right eyelid and lashes from the inner to the outer canthus.
- 2Instill the prescribed number of timolol maleate drops into the lower conjunctival sac.
- 3Apply gentle pressure over the nasolacrimal duct with a clean tissue for one to two minutes.
- 4Wait for approximately five minutes before proceeding with the next medication.
- 5Extrude a thin ribbon of erythromycin ointment along the inside of the lower eyelid.
- 6Instruct the client to gently close their eyes and move them around.
Answer
The correct sequence is to first cleanse the eye, then instill the drops, apply nasolacrimal pressure, wait five minutes, apply the ointment, and finally instruct the client to gently close and roll their eyes.
The correct sequence ensures that the eye is properly prepared, the aqueous medication (timolol) is absorbed without causing dangerous systemic side effects, and the lipid-based medication (erythromycin) does not block the absorption of the drops.
Step-by-Step Solution
Key Concept
Administration Sequence for Multiple Ophthalmic Medications