A Nursing officer is working in eye ward. A doctor ordered for a specific eye disease an ointment and an eye drops, a prudent nursing officer should administer which type of medicine first?

1. A

   Eye drops

2. B

   Eye ointment

3. C

   Both simultaneously

4. D

   None of these

Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)

Explanation

• The correct procedure is to administer eye drops before eye ointment to ensure maximum therapeutic effect.
• Eye drops are liquid and are absorbed quickly by the eye.
• Eye ointments are thicker and oil-based; if applied first, they would create a barrier, preventing the absorption of the subsequently administered drops.
• A waiting period of at least 3-5 minutes between instilling drops and applying ointment is recommended to allow for proper absorption of the drops.

Why Other Options Were Wrong

• Option B: Applying eye ointment first is incorrect because its greasy base will coat the conjunctiva and prevent the absorption of the eye drops, rendering them ineffective.
• Option C: Administering both simultaneously is incorrect. This would cause the medications to mix, diluting their concentrations and interfering with the proper absorption and action of both drugs.
• Option D: This option is incorrect because there is a specific, correct order of administration that ensures the effectiveness of the medications.

Related Visual

Clinical Relevance

• Nursing practice connection: Knowing Pharmacology: Ophthalmic Medication Administration helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
• Ensuring proper medication administration sequence is critical for patient safety and treatment efficacy. Incorrect order can lead to treatment failure.
• Patient education is a key nursing responsibility. Nurses must teach patients and their families the correct procedure for instilling multiple types of eye medications at home.
• What if? If two different types of eye drops are prescribed, the nurse should wait at least 5 minutes between each type of drop to prevent one from washing out the other. A suspension should generally be administered after a solution.

How to Approach the Question

• First, identify the core of the question, which is about the correct sequence of administering two different forms of ophthalmic medication (liquid drops vs. semi-solid ointment).
• Recall the basic principles of drug absorption. Liquids are generally absorbed faster than semi-solids.
• Consider the physical properties of each medication. Eye drops are watery and will spread over the eye surface. Ointments are thick and greasy, creating a film.
• Logically deduce that applying the thick ointment first would create a barrier, blocking the liquid drops from reaching the eye surface for absorption.
• Therefore, the liquid drops must be administered first. Allow time for absorption before applying the ointment.
• Select the option that reflects this correct sequence.

Concept Tested & Keywords

• Concept Tested: Pharmacology: Ophthalmic Medication Administration
• Stem keywords: eye ward, eye disease, ointment, eye drops, administer first
• Lead-in keywords: which type of medicine first
• Clinical cues: The care setting changes urgency, monitoring level, and the expected nursing action.

Question ID

QMsKPZPYoOiK6COwxscsu_

Copy ID

Reference Book

E6 Pharmacology Nursing Lilley 11e Part 3 p. 269-271

E6 Pharmacology Nursing Lilley 11e Part 1 p. 146-148