EENT and Sleep Disorders Q 60 - Gyan Darpan : Learning Portal
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Tuesday, 22 March 2022

EENT and Sleep Disorders Q 60

During eyedrop instillation, which intervention would the nurse perform to prevent systemic adverse effects from drug absorption?
     A. Applying pressure on the eyelid rim.
     B. Having the client close his eyes tightly.
     C. Placing the client in the supine position for a few minutes.
     D. Applying pressure on the inner canthus.

Correct Answer: D. Applying pressure on the inner canthus.

Systemic absorption and subsequent adverse effects may occur if the medication enters the nasolacrimal canal. The nurse, therefore, applies pressure to the inner canthus, causing occlusion of this canal and minimizing the risk for systemic adverse effects. Systemic absorption (SA) of eye drops and ointments occurs via the conjunctival blood vessels or the nasal mucosa. This is a particular issue when drugs such as beta-blockers are prescribed (Marsden, 2007).

Option A: Applying pressure on the eyelid rim would not occlude this canal. For example, the beta-blocker timolol can cause bronchoconstriction, hypotension, bradycardia, nausea, diarrhea, anxiety, depression, hallucinations, and fatigue. These effects can be reduced through the use of punctal occlusion (keeping the eye closed for a slow count of 60) after administration.
Option B: Having the client close his eyes tightly may cause some of the medication to be expelled. Alternatively, the patient can apply digital pressure to the tear drainage system at the nasal corner of the closed eyelids. These techniques minimize the amount of drug being taken into the nasolacrimal system and into the systemic circulation.
Option C: Positioning has no effect on the blood flow of medication into the nasolacrimal canal and subsequent absorption. Position the patient comfortably, either sitting or lying down (semi-prone or recumbent) with the head supported.

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