Ocular Anesthetics and Lubricants

Every question here, with the answer

1. After a corneal foreign body is removed under proparacaine drops, the client's eye still feels numb. Which instruction is most important?

   1. Instill more anesthetic drops at home when it hurts.
   2. Do not touch the eye while it is numb.
   3. Apply a warm compress immediately.
   4. Rub the eye gently to restore feeling.

   Answer: Do not touch the eye while it is numb.

   Clients should not touch a numb eye because the lack of sensation can lead to accidental injury. Rubbing the eye is unsafe, and repeated anesthetic use at home risks corneal opacity and vision loss.

2. A nurse sees an unfamiliar ophthalmic drug on a procedure tray whose name ends in "-caine." What can the nurse conclude?

   1. It is an ocular corticosteroid.
   2. It is an ocular lubricant.
   3. It is an ocular anesthetic.
   4. It is an ocular antibiotic.

   Answer: It is an ocular anesthetic.

   All ocular anesthetic medications end in the suffix "caine," which lets the nurse identify an unfamiliar drug as an anesthetic. Lubricants, antibiotics and steroids are not identified by this suffix.

3. A client who had eye surgery under a topical ocular anesthetic starts to report increasing eye pain. How should the nurse interpret this?

   1. The anesthesia is wearing off.
   2. The client is allergic to lubricants.
   3. Pain is a sign the anesthetic is still working.
   4. The client needs artificial tears.

   Answer: The anesthesia is wearing off.

   The nurse should be especially aware of pain level because it indicates the anesthesia is wearing off. The other interpretations are not supported by the section.

4. A client asks for extra anesthetic eye drops to take home because they relieved the pain so well. Which points should the nurse include in the response? Select all that apply.

   1. Prolonged use can lead to vision loss.
   2. Home use prevents the need for follow-up.
   3. The drops can alter perception and contribute to a fall.
   4. The drops are safe to use as often as needed.
   5. Prolonged use can cause permanent corneal opacity.

   Answer: Prolonged use can lead to vision loss., The drops can alter perception and contribute to a fall., Prolonged use can cause permanent corneal opacity.

   Prolonged or misused topical ocular anesthetics can cause corneal opacification with vision loss, and the drops can alter perception and lead to falls. They are not safe for unlimited use and do not replace follow-up.

5. A nurse is caring for an intubated client who is not blinking and receives ocular lubricant ointment. Which nursing actions are appropriate? Select all that apply.

   1. Assess the eyes frequently.
   2. Use a damp cloth to remove prior lubricant before the next application.
   3. Cleanse the areas around the eyes and face.
   4. Observe for rash or swelling of the face as signs of hypersensitivity.
   5. Leave old ointment in place to build a thicker layer.

   Answer: Assess the eyes frequently., Use a damp cloth to remove prior lubricant before the next application., Cleanse the areas around the eyes and face., Observe for rash or swelling of the face as signs of hypersensitivity.

   For clients who cannot blink, the nurse assesses the eyes often, removes prior lubricant with a damp cloth to avoid buildup or crusting, cleanses the face, and watches for hypersensitivity. Leaving old ointment causes the buildup the nurse is trying to avoid.

6. A client using artificial tears notices the solution in the bottle has turned cloudy. What should the nurse advise?

   1. Warm the bottle until it clears.
   2. Do not use the solution.
   3. Use it only at bedtime.
   4. Shake the bottle and keep using it.

   Answer: Do not use the solution.

   Artificial tears are clear isotonic solutions and should not be used if the color changes or the solution becomes cloudy. Shaking, warming or limiting use does not make a changed solution safe.