Ocular Anti-inflammatories and Anti-infectives

Every question here, with the answer

1. A client using ketorolac eye drops after cataract surgery for three weeks reports worsening eye pain, and the provider finds corneal epithelial breakdown. What should the nurse expect?

   1. Continue the drops and add artificial tears.
   2. Add latanoprost to speed healing.
   3. Double the dose to control inflammation.
   4. Stop the topical NSAID immediately and monitor corneal healing closely.

   Answer: Stop the topical NSAID immediately and monitor corneal healing closely.

   Clients with corneal epithelial breakdown should immediately stop topical NSAIDs and be closely monitored for corneal healing. Continuing or increasing the drug risks further damage, and NSAIDs reduce latanoprost's effect rather than helping healing.

2. A client has been using prednisolone eye drops for two weeks for uveitis. Which assessment is most important?

   1. Routine intraocular pressure checks
   2. Serum potassium level
   3. Hearing test
   4. Daily weight

   Answer: Routine intraocular pressure checks

   Extended use of ocular corticosteroids can raise IOP and lead to glaucoma, so anyone using them more than 10 days should have IOP checked routinely. The other assessments are not described for ocular steroids.

3. A parent asks whether their child with bacterial conjunctivitis who started antibiotic eye drops this morning can return to day care today. What should the nurse explain?

   1. The child is no longer contagious after the first dose.
   2. Bacterial eye infections remain contagious until treated for 24–48 hours.
   3. The child is contagious until the bottle is finished.
   4. Bacterial conjunctivitis is never contagious.

   Answer: Bacterial eye infections remain contagious until treated for 24–48 hours.

   Bacterial infections remain contagious until treated for 24–48 hours. The first dose does not end contagiousness, and there is no requirement to finish the bottle before the child is no longer contagious.

4. A client is prescribed trifluridine eye drops for herpes simplex keratitis. Which teaching points should the nurse include? Select all that apply.

   1. Store the medication in the refrigerator.
   2. Report floaters, flashes of light or a curtain-like shadow immediately.
   3. Once symptoms go away, the virus is gone for good.
   4. Let the drops reach room temperature before instilling them.
   5. Wash face, hands and any exposed skin after handling the drug.

   Answer: Store the medication in the refrigerator., Report floaters, flashes of light or a curtain-like shadow immediately., Let the drops reach room temperature before instilling them., Wash face, hands and any exposed skin after handling the drug.

   Trifluridine is refrigerated, instilled at room temperature, and handled with thorough washing; floaters, flashes or a curtain-like shadow may signal retinal detachment. Herpes lies dormant, so the client should not assume the organism is eliminated.

5. A client being treated for a corneal ulcer with ciprofloxacin eye drops is found on day 4 to have a white crystalline deposit on the corneal defect. How should the nurse interpret this?

   1. It is a sign of hypersensitivity; stop the drug.
   2. It means the ulcer is perforating.
   3. It is a fungal superinfection requiring an antifungal.
   4. It is a nonharmful precipitate that resolves on its own.

   Answer: It is a nonharmful precipitate that resolves on its own.

   During the first 7 days of ciprofloxacin treatment for a corneal ulcer, a nonharmful white crystalline precipitate commonly forms and resolves without corneal damage. It is not described as superinfection, hypersensitivity or perforation.

6. A client is going home with an ocular antibacterial. Which instructions are appropriate? Select all that apply.

   1. Keep driving even if vision is blurred.
   2. Wash off eye makeup and wash hands before each dose.
   3. Seek immediate care for severe eye redness or swelling of the lips or face.
   4. Do not wear contact lenses during the course of treatment.
   5. Let the dropper tip touch the eye to measure the dose.

   Answer: Wash off eye makeup and wash hands before each dose., Seek immediate care for severe eye redness or swelling of the lips or face., Do not wear contact lenses during the course of treatment.

   Clients should wash off makeup and hands, avoid contact lenses during treatment and seek care for hypersensitivity signs. Touching the eye with the dropper contaminates it and raises superinfection risk, and clients should not drive with blurred vision.