A practical nurse (PN) is preparing to administer prescribed timolol eye drops to a client diagnosed with glaucoma. Assuming hand hygiene has been performed and clean gloves are applied, in what order should the PN perform the following steps?
- 1Cleanse the client's eyelid and eyelashes, wiping from the inner to the outer canthus.
- 2Instruct the client to tilt their head back slightly and look up at the ceiling.
- 3Gently pull down the client's lower eyelid using a thumb or index finger to expose the conjunctival sac.
- 4Instill the prescribed number of drops into the center of the lower conjunctival sac.
- 5Apply gentle pressure to the client's nasolacrimal duct for 30 to 60 seconds.
Answer
The correct sequence is to first cleanse the eye, position the client looking upward, expose the conjunctival sac, instill the medication into the sac, and finally apply pressure to the nasolacrimal duct.
The proper sequence for ophthalmic administration prioritizes infection control, client safety, and the prevention of systemic absorption. Cleansing the eye first prevents the introduction of debris. Proper positioning and exposing the conjunctival sac protect the highly sensitive cornea from injury. Instilling the medication into the sac ensures even distribution. Finally, applying pressure to the nasolacrimal duct is a critical safety step to prevent systemic effects of the medication.
Step-by-Step Solution
Key Concept
Safe Administration of Ophthalmic Medications