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Chapter 34: Problem 675

A client presents to the emergency department with a foreign object in the eye. Which action should the nurse take? A. Remove the object after an x-ray is taken. B. Remove the object after notifying the ophthalmologist. C. Leave the object untouched while awaiting the ophthalmologist.. D. Flush the eye with saline to dislodge the object.

Short Answer

Expert verified
C. Leave the object untouched while awaiting the ophthalmologist.

Step by step solution

01

Read the Question Carefully

Understand what the question is asking. A client has a foreign object in their eye and the nurse must decide on the appropriate action to take.
02

Review the Given Options

Consider each option provided: A. Remove the object after an x-ray is taken. B. Remove the object after notifying the ophthalmologist. C. Leave the object untouched while awaiting the ophthalmologist. D. Flush the eye with saline to dislodge the object.
03

Evaluate Each Option

Analyze the suitability of each action: Option A suggests removing the object after an x-ray which could cause further injury and should typically only be done by a specialist. Option B suggests removing the object after notifying the ophthalmologist, which may still result in further injury without proper assessment. Option C involves leaving the object untouched, which prevents additional harm until a specialist can attend. Option D suggests flushing the object out, which could also cause further damage if not done properly.
04

Determine the Safest Option

Consider that immediate removal or movement of the object might exacerbate any injury. Waiting for a specialist to properly address the situation minimizes risk of additional harm.
05

Make a Decision

Given the potential complications from improper removal or flushing, the safest approach is to leave the object untouched until the ophthalmologist arrives.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

foreign object in eye management
When a client presents with a foreign object in the eye, proper management is crucial to avoid further damage. The primary goal is to stabilize the situation until a specialist can assess and treat the injury. It's important not to touch or attempt to remove the object, as this can exacerbate the damage. Waiting for an ophthalmologist ensures that the object will be removed under sterile conditions and with the appropriate tools. Using saline to flush the eye may seem like a quick fix, but it can push the object deeper, causing more harm. The recommended action is to reassure the patient, keep them calm, and cover the affected eye to prevent any movement until help arrives.
nursing actions in emergency
Emergencies require prompt and effective nursing actions. When managing a patient with an eye injury, prioritize assessment and stabilization. Begin with a thorough check-up to understand the extent of the injury. Avoid any actions that could worsen the situation before a specialist arrives. Place the patient in a comfortable position, advise them not to rub the affected eye, and cover it with a clean cloth or eye shield if available. Always document the situation, including the time of the incident and any interventions performed. Effective communication with the rest of the healthcare team ensures that the patient receives timely and appropriate care.
patient safety procedures
Patient safety is the cornerstone of nursing care, particularly in emergency situations. Follow these principles to ensure safety:
  • Avoid unnecessary movements or interventions that could cause further injury.
  • Keep the patient informed about each step to reduce anxiety.
  • Use personal protective equipment (PPE) to protect both the patient and yourself from infection.
  • Adhere to protocols for infection control, especially if an object needs to be left in place.
  • Ensure that the necessary medical equipment is available and in good working condition.
Consistent application of these safety procedures minimizes the risk of complications and supports the best possible outcomes for the patient.

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Most popular questions from this chapter

Due to a severe asthma attack, a client has been on corticosteroids for more than 2 weeks. Which information should the nurse give the client about when the time comes to stop the medication? A. Fluid intake will need to be limited. B. The dose of medication will be tapered down slowly. C. Extra calcium will be needed for a week to ten days, D. Vitamin supplements will be needed to prevent bone loss.

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Which is an appropriate guideline for the nurse to utilize when communicating with an adolescent? A. Reassure that what he or she is going through is understood. B. Invite the parents to be present when talking with the adolescent. C. Ask meaning of expressions if not clearly understood as a result of teen culture. D. Share with the parents information received in their absence.

Which finding when reviewing the record of an elderly client would the nurse interpret as a normal occurrence with aging? A. Very concentrated urine B. Microscopic hematuria C. Occasional urinary incontinence D. Decreased glomerular filtration rate
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