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Difficulty: MediumPharmacological Therapies

A practical nurse is preparing to administer prescribed ophthalmic drops to a client diagnosed with glaucoma. Arrange the steps of the procedure in the correct chronological order. All steps must be used.

  1. 1Cleanse the eyelid and eyelashes using a clean tissue from the inner to the outer canthus.
  2. 2Instruct the client to tilt their head backward and look up toward the ceiling.
  3. 3Gently pull the lower eyelid downward against the cheekbone to expose the conjunctival sac.
  4. 4Hold the dropper 1 to 2 cm above the eye and instill the medication into the conjunctival sac.
  5. 5Apply gentle pressure to the nasolacrimal duct for 30 to 60 seconds.

Answer

First cleanse the eye from inner to outer canthus, then position the client looking up, expose the conjunctival sac, instill the drops into the sac, and finally apply pressure to the nasolacrimal duct.
This chronological sequence ensures optimal medication delivery while prioritizing client safety. Cleaning the eye prevents infection, correct positioning reduces the blink reflex, exposing the sac ensures accurate delivery, and nasolacrimal pressure limits unintended systemic absorption.

Step-by-Step Solution

1
Cleanse the eyelid and eyelashes.
The eye area is free of drainage and debris.
Wiping from the inner to outer canthus prevents sweeping pathogens into the nasolacrimal duct.
2
Position the client's head backward and instruct them to look up.
The cornea rotates away from the lower lid.
Looking up decreases the natural blink reflex and prevents the medication drop from directly hitting the sensitive cornea.
3
Pull the lower eyelid downward.
The conjunctival sac is exposed.
This creates a trough or pocket to safely catch and hold the liquid medication.
4
Instill the prescribed number of drops into the conjunctival sac.
The medication is delivered to the eye.
Holding the dropper 1 to 2 cm away prevents accidental contact with the eye, which could cause injury or contaminate the dropper.
5
Apply gentle pressure to the nasolacrimal duct.
The tear duct is temporarily occluded.
Occluding the duct prevents the medication from draining into the nasal cavity and entering the systemic circulation, reducing the risk of systemic side effects.

Key Concept

Safe Administration of Ophthalmic Medications
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Topics

Pharmacological Therapies

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