Nurse has to apply erythromycin ointment to a newborn child. Which area of eye she is supposed place it?

OSSSC Nursing Officer-2023

Child Health Nursing (Pediatrics)

Easy

Appeared in: OSSSC Nursing Officer-2023

Explanation

The correct site for applying erythromycin ointment is the lower conjunctival sac.
This location acts as a pouch, allowing the medication to be distributed across the entire eye surface as the newborn blinks.
Applying the ointment into the lower sac prevents direct contact with and potential injury to the sensitive cornea.
The standard procedure involves gently pulling down the lower eyelid to expose the conjunctival sac and applying a thin ribbon of ointment from the inner to the outer canthus.

Option A: Applying ointment directly onto the cornea can cause irritation, pain, and corneal abrasion, which could lead to vision problems.
Option B: This term is too vague for a professional nursing procedure. The specific and correct location is the lower conjunctival sac, which is located under the lower eyelid.
Option D: Accessing the upper conjunctival sac is difficult, more uncomfortable for the newborn, and is not the standard procedure for this prophylaxis.

Clinical Relevance

Nursing practice connection: Use the key finding related to Medication Administration: Neonatal Eye Prophylaxis to guide bedside assessment, documentation, and the next nursing action.
Erythromycin eye ointment is administered as a prophylactic measure to prevent ophthalmia neonatorum, a severe eye infection caused by Neisseria gonorrhoeae or Chlamydia trachomatis, which the newborn can acquire during passage through the birth canal.
This is a mandatory procedure in many regions and a critical nursing intervention to prevent neonatal blindness.
What if? If the parents refuse the medication, the nurse must first educate them on the risks of ophthalmia neonatorum and the benefits of the prophylaxis. If they still refuse, the nurse must document the refusal in the medical record according to facility policy and inform the healthcare provider.

How to Approach the Question

First, identify the core task in the question: applying eye ointment to a newborn.
Recall the specific procedure for ophthalmic medication administration. The primary goals are safety and effectiveness.
Visualize the anatomy of the eye. The conjunctival sac is a natural pouch ideal for holding medication.
Evaluate the options based on safety and standard nursing practice. Direct application to the cornea is always incorrect due to the high risk of injury.
Compare the remaining options for precision. 'Lower conjunctiva' is the most specific and professionally accurate term for the target location, making it the best answer over the vague 'under the eyelid'.

Concept Tested & Keywords

Concept Tested: Medication Administration: Neonatal Eye Prophylaxis
Stem keywords: erythromycin ointment, newborn child, area of eye
Lead-in keywords: Which area
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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