Drugs for Glaucoma

Understanding Pharmacology Essentials for Medication Safety

Nursing
21
Questions
0
True/False
18
Choices
3
Essay
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Questions

Q1
Free

How does untreated elevated intraocular pressure eventually lead to visual impairment?

Multiple Choice
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A) It compresses blood vessels and causes hypoxia of the photoreceptors.
B) It clouds the lens and prevents light from striking the photoreceptors.
C) It constricts the pupil and prevents light from entering the posterior chamber.
D) It pushes the cornea forward and distorts the placement of the image on the retina.
Answer:
A) It compresses blood vessels and causes hypoxia of the photoreceptors.

Explanation:
The photoreceptors of the retina are the part of the sensory nerve that respond to light and enable vision. These receptors require a constant supply of oxygen. Higher than normal intraocular pressure compresses retinal vessels and limits or prevents blood flow to these receptors. As a result of this lack of oxygen, the receptors die and are not replaced. Loss of any photoreceptors reduces vision. Loss of them all causes total blindness.
Q2
Free

Which statement regarding primary open-angle glaucoma (POAG) is true?

Multiple Choice
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A) It is most common in children.
B) The major cause is trauma to the eye.
C) The problem usually affects both eyes.
D) The first symptom is chronic eye pain.
Answer:
C) The problem usually affects both eyes.

Explanation:
POAG is the most common form of glaucoma and is much more common in older adults. It does not occur as a result of trauma and usually affects both eyes, although one eye may be affected to a greater degree than the other.
Q3
Free

Which precaution is most important for the nurse to teach a patient who is prescribed any type of eye drug administered as eye drops?

Multiple Choice
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A) Apply only the number of drops prescribed.
B) Stop the drug immediately if eye redness occurs.
C) Wear dark glasses for 1 hour after placing the eye drops.
D) Apply pressure to the corner of the eye after the drug has been placed.
Answer:
A) Apply only the number of drops prescribed.

Explanation:
Not only can eye drops enter the circulatory system and have systemic effects, excessive drops for some types of drugs for glaucoma can reduce intraocular pressure to dangerously low levels. Many patients do not consider any topical drug, including eye drops, to be real medication and believe that more drug is better. Patients must be taught to use all eye drugs exactly as prescribed, and not use more drug than is prescribed.
Q4

Which safety precaution does the nurse teach a patient who is prescribed eye drops or eye ointment?

Multiple Choice
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A) Wash your hands before and after applying the drug.
B) Do not share your eye medications with anyone else.
C) Avoid drinking alcoholic beverages while taking this drug.
D) Do not drive or use heavy equipment while your vision is blurred.
Answer:

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Q5

Which assessment is most important for the nurse to perform before instilling latanoprost (Xalatan) into a patients eyes?

Multiple Choice
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A) Measure the patients temperature.
B) Measure the patients intraocular pressure.
C) Check the cornea for abrasions or open areas.
D) Assess heart rate and rhythm for 1 full minute.
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Q6

A patient has been taking bimatoprost (Lumigan) for the last 2 months. Which statement by the patient indicates to the nurse a correct understanding of this drug therapy?

Multiple Choice
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A) When my eyes are red or itchy, I should wait until the next day to use my glaucoma medicine.
B) Even though my intraocular pressure is now normal, I will continue to take the drug once daily.
C) One indication that I have used too much of this drug is when my vision becomes blurry or fuzzy.
D) If I forget to take the eye drops one day, I should apply them as soon as I remember them the next day and also take the regular dose for that day.
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Q7

A patient who has been using travoprost (Travatan) eye drops for glaucoma reports that the eye lashes seem longer and thicker. What is the nurses best action?

Multiple Choice
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A) Teach the patient that the drug is absorbed by the blood vessels of the eye and has no effect on other eye or lid structures.
B) Instruct the patient to apply only the number of drops prescribed and to blot the area with cotton balls after each dose.
C) Remind the patient that eye drops are liquid and that wet lashes appear both longer and thicker.
D) Reassure the patient that this is an expected response to the drug and no action is needed.
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Q8

How do beta-adrenergic blocking agents (antagonists) lower intraocular pressure?

Multiple Choice
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A) They increase the rate that the vitreous humor is reabsorbed.
B) They slow the production of aqueous humor inside the eye.
C) They reduce systemic blood pressure, which results in lower intraocular pressure.
D) They increase the movement of aqueous humor from the posterior chamber into the anterior chamber.
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Q9

A patient is prescribed an ophthalmic beta-blocking agent for the treatment of glaucoma. Which precaution does the nurse teach the patient to prevent orthostatic hypotension?

Multiple Choice
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A) Change positions slowly.
B) Take your pulse rate at least four times each day.
C) Be sure to lie down for at least 10 minutes after putting the drops into your eyes.
D) Apply pressure to the inside corner of your eye when putting the drops into the eye.
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Q10

A patient who has been prescribed timolol (Timoptic) for the last month reports that his asthma is worse. What is the nurses best response?

Multiple Choice
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A) Check the patients breath sounds and pulse rate.
B) Hold the dose and notify the prescriber immediately.
C) Ask the patient what drugs he takes to control his asthma.
D) Reassure the patient that this is an expected response and requires no action.
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Q11

What is the most important assessment question for the nurse to ask a patient who is newly prescribed apraclonidine (Iopidine) for glaucoma?

Multiple Choice
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A) How long have you had glaucoma?
B) What other medications are you currently taking?
C) Have you had any difficulty with retaining urine?
D) Do you have asthma or any chronic respiratory problem?
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Q12

Which assessment is most important for the nurse to perform after administering the first dose of dipivefrin (Propine) to a patient with glaucoma?

Multiple Choice
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A) Compare urine output with fluid intake.
B) Listen to breath sounds bilaterally.
C) Assess level of consciousness.
D) Check pupil size.
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Q13

When the nurse shines a penlight into the eyes of a patient who is prescribed brimonidine (Alphagan P), the pupils of both eyes remain equally dilated. What is the nurses best action?

Multiple Choice
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A) Document the response as the only action.
B) Hold the next dose and notify the prescriber.
C) Assess the patients hand grasp strength bilaterally.
D) Remind the patient to wear sunglasses when outdoors.
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Q14

What is the most important action for the nurse to perform after administering eye drops to a patient who is prescribed pilocarpine (Ocu-Carpine)?

Multiple Choice
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A) Place the patient in the supine position.
B) Wipe the excess drug from the patients skin.
C) Instruct the patient to keep the eyes closed for 2 minutes.
D) Check pupillary responses by shining a penlight into each eye.
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Q15

A patient who has been prescribed echothiophate (Phospholine Iodide) for the last 2 weeks reports all of the following symptoms or conditions. Which symptom or condition does the nurse report to the prescriber immediately?

Multiple Choice
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A) Excessive drooling
B) Pinpoint pupils
C) Cold hands
D) Dry mouth
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Q16

What is the most important precaution for the nurse to teach an older patient who is prescribed a glaucoma drug that causes miosis?

Multiple Choice
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A) Wear sunglasses until the drug wears off.
B) Use at least a 30 SPF sunscreen when going outdoors.
C) Avoid driving or operating hazardous machinery until the drug wears off.
D) Increase the light indoors because vision will be decreased in low-light environments.
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Q17

Which question is most important for the nurse to ask a patient who is prescribed acetazolamide (Diamox) before administering the first dose?

Multiple Choice
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A) Do you have diabetes?
B) Are you allergic to sulfa drugs?
C) How long have you had glaucoma?
D) Do you eat grapefruit or drink grapefruit juice?
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Q18

Why are carbonic anhydrase inhibitors not recommended for use in children with glaucoma?

Multiple Choice
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A) Their use increases the risk for cataracts.
B) Growth is inhibited with use of carbonic anhydrase inhibitors.
C) These drugs could reduce intraocular pressure below normal levels.
D) Carbonic anhydrase inhibitors are known to cause birth defects in animals.
Answer:

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Q19

[Multiple Response] Which nursing actions help prevent infection when placing ointments into a patients eye? (Select all that apply.)
a. Having the patient remove contact lenses
b. Avoiding touching the tip of the applicator
c. Using separate drug tubes for the right and the left eye
d. Applying pressure over the punctum for 1 minute after instilling the drug
e. Waiting 10 minutes between the administration of more than one type of eye drug
f. Squeezing out and discarding a small amount of ointment before instilling the drug

Essay
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Answer:

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Q20

[Multiple Response] Which nursing actions help prevent infection when placing ointments into a patients eye? (Select all that apply.)
a. Having the patient remove contact lenses
b. Avoiding touching the tip of the applicator
c. Using separate drug tubes for the right and the left eye
d. Applying pressure over the punctum for 1 minute after instilling the drug
e. Waiting 10 minutes between the administration of more than one type of eye drug
f. Squeezing out and discarding a small amount of ointment before instilling the drug

Essay
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Q21

A patient is prescribed methazolamide (Neptazane) 75 mg orally. The drug available is methazolamide 25 mg per tablet. How many tablets does the nurse administer to the patient? _____ tablet(s)

Essay
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