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

Appeared in: DHS Staff Nurse - 2018 (Shift-2nd)

Explanation

The primary principle is that for a topical medication to be effective, it must make direct contact with the target tissue.
In conjunctivitis, exudate (discharge or crust) can form a barrier over the conjunctiva, preventing the eye drops from reaching the surface where they are needed.
Cleansing the eye with warm water removes this barrier, ensuring the medication can work effectively.
The correct cleansing technique, wiping from the inner to the outer canthus, prevents microorganisms and debris from being washed into the nasolacrimal duct.

Option B: A 6-year-old child typically lacks the fine motor skills, coordination, and understanding of aseptic technique required to safely and effectively self-administer eye drops.
Option C: In a hospital setting, the nurse is legally and professionally responsible for medication administration to ensure it is done correctly, safely, and documented properly. While family education is crucial for discharge, the nurse performs the task during hospitalization.
Option D: Antibiotic or anti-infective treatments must be completed as prescribed, even if symptoms improve. Stopping medication early can lead to a relapse of the infection and contribute to antibiotic resistance.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Medication Administration in Pediatrics in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Ensuring medication efficacy is a core nursing responsibility. Failing to cleanse the eye first can lead to treatment failure.
Patient education is critical. The nurse must use the opportunity of administering the medication to teach the family the correct technique for when they continue treatment at home.
Infection control is paramount. Using a new, clean cloth for each wipe and washing hands before and after prevents cross-contamination to the other eye or to other people.

How to Approach the Question

First, identify the key elements of the scenario: a 6-year-old child, a diagnosis of conjunctivitis, and the task of administering eye drops.
Consider the pathophysiology of conjunctivitis, which often includes exudate or crusting.
Evaluate each option based on the principles of safe and effective medication administration.
Option A addresses a necessary preparatory step to ensure the medication can work. Ask yourself: 'Is there a barrier to the medication?' Yes, the exudate.
Options B and C relate to who performs the task. Consider the patient's age and the nurse's professional responsibility in a hospital setting.
Option D relates to the duration of treatment. Recall the principle of completing antibiotic courses to prevent resistance and relapse.

Concept Tested & Keywords

Concept Tested: Medication Administration in Pediatrics
Stem keywords: 6-year-old, conjunctivitis, eye drops, administering
Lead-in keywords: essential to consider
Clinical cues: Patient is a 6-year-old, which requires consideration of developmental stage.
Clinical cues: Diagnosis is conjunctivitis, which often involves 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 DHS Staff Nurse - 2018 (Shift-2nd)

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