NHM UP Staff Nurse-2023 shift 1st
Nursing Foundation
Medium
The eyes of an unconscious patient should be cleaned from _________.
Appeared in: NHM UP Staff Nurse-2023 shift 1st
Explanation
- The correct procedure is to clean the eye from the inner canthus (near the nose) to the outer canthus (near the temple).
- This direction of cleaning follows the principle of moving from a cleaner area to a dirtier area.
- The primary reason for this technique is to prevent debris and microorganisms from being washed into the nasolacrimal (tear) duct, which is located at the inner canthus.
- Pushing contaminants into the tear duct can lead to blockages and serious infections (dacryocystitis) or even systemic infection.
Why Other Options Were Wrong
- Option B: Cleaning from the outer to the inner canthus moves debris and pathogens directly towards the nasolacrimal duct, increasing the risk of infection and blockage.
- Option C: Starting from the middle of the eye and moving to the outer canthus is an incomplete cleaning method. It fails to clean the inner portion of the eye and can push debris from the center towards the outer corner without effectively removing it.
- Option D: Starting from the middle and moving to the inner canthus is incorrect for the same reason as option B; it moves potential contaminants towards the highly sensitive nasolacrimal duct.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Aseptic technique in providing eye care to an unconscious patient to guide bedside assessment, documentation, and the next nursing action.
- Proper eye care in unconscious or sedated patients is a fundamental nursing responsibility to prevent serious and painful complications like corneal abrasions, keratitis, and permanent vision damage.
- Failure to perform this simple procedure correctly can lead to hospital-acquired infections and increased patient morbidity.
- What if? If the patient had an active infection with significant purulent discharge in the outer canthus only, the principle remains the same. You would still clean from inner to outer to avoid contaminating the nasolacrimal duct, but you would use extra care and multiple swabs to remove the heavy discharge without spreading it.
How to Approach the Question
- First, identify the core principle of the question, which is medical asepsis (preventing the spread of infection).
- Recall the relevant anatomy of the eye, specifically the location of the nasolacrimal (tear) duct at the inner canthus.
- Apply the 'clean to dirty' principle. The goal is to move contaminants away from sensitive or sterile areas.
- In this context, moving debris away from the tear duct is the priority. Therefore, the cleaning motion must be away from the inner canthus.
- Evaluate the options: Only 'inner to outer canthus' moves potential contaminants away from the nasolacrimal duct. All other options either move debris towards the duct or are incomplete.
Concept Tested & Keywords
- Concept Tested: Aseptic technique in providing eye care to an unconscious patient.
- Stem keywords: unconscious patient, eyes, cleaned
- Lead-in keywords: from
- Clinical cues: The patient's state of being 'unconscious' is a key clinical cue, as it implies the absence of a protective blink reflex, making proper eye care critical.
Question ID
QudaQPelGhI_IAhAsfuiq3
Reference Book
E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 187-189
E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 212-214
Practise the full NHM UP Staff Nurse-2023 shift 1st
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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