The nurse is caring for a 6 -year-old client admitted with the diagnosis of conjunctivitis. Before administering eyedrops, the nurse should recognize that it is essential to consider?

Appeared in: SJH Nursing Officer - 2019

Explanation

Exudate and crusting from conjunctivitis can form a physical barrier, preventing the eyedrop from reaching the conjunctival sac.
Cleansing the eye from the inner to the outer canthus removes this barrier and reduces the local microbial load.
This preparatory step is essential to ensure the medication is effective and can be properly absorbed to treat the infection.
This is a standard and critical step in the procedure for administering ophthalmic medications for infectious conditions.

Option B: A 6-year-old lacks the developmental maturity, fine motor skills, and understanding of asepsis to safely self-administer eye drops.
Option C: While parent education is important for discharge, the nurse is responsible for administering medication to an admitted patient. The most essential procedural step before instillation is cleansing the eye, not delegating the task.
Option D: Antimicrobial therapy must be completed for the full prescribed duration to prevent relapse and the development of drug resistance.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Pediatric Ophthalmic Medication Administration in the correct sequence, documenting the action clearly, and monitoring for the expected response.
This question highlights the principle of 'Right Technique' in medication administration. Proper preparation of the site is as important as the medication itself.
Conjunctivitis is highly contagious. Nurses must emphasize strict hand hygiene and educate families not to share towels, pillows, or washcloths to prevent spreading the infection to others.
What if? If the conjunctivitis was allergic rather than infectious, there might be less exudate, but the eye could be very itchy and watery. The principle of cleansing away any debris or allergens before instilling anti-allergy drops would still be beneficial for comfort and effectiveness.

How to Approach the Question

First, identify the key elements of the question: a 6-year-old child, a diagnosis of conjunctivitis, and the task of administering eyedrops.
Focus on the lead-in phrase: 'essential to consider'. This asks for the most critical principle or action.
Consider the pathophysiology of conjunctivitis. It's an infection or inflammation that often produces discharge (exudate).
Evaluate each option in the context of safe and effective medication administration. Ask yourself, 'What must be done to ensure the medicine works as intended?'
Option A addresses a direct barrier (exudate) to medication effectiveness. This is a fundamental preparatory step.
Options B, C, and D relate to who administers the drug or the decision to give it, but they are not the most essential procedural step required before instillation to ensure efficacy.

Concept Tested & Keywords

Concept Tested: Pediatric Ophthalmic Medication Administration
Stem keywords: 6-year-old, conjunctivitis, administering eyedrops
Lead-in keywords: essential to consider
Clinical cues: Patient is a 6-year-old, which requires specific techniques for cooperation and safety.
Clinical cues: Diagnosis is conjunctivitis, which implies the presence of infection and likely exudate.

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E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 187-189

E6 Nursing Fundamentals Taylor p. 866-868

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

Practise the full SJH Nursing Officer - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.