A nurse is demonstrating the correct technique for instilling ...

[brutforce]

A nurse is demonstrating the correct technique for instilling antibiotic ear drops into a child's ear canal. The nurse should teach the child's caregivers to do which of the following?
 
  A) Have the child lie supine during instillation of the ear drops.
  B) Have the child lie still for 30 to 45 minutes after instilling the ear drops.
  C) Place a cotton ball in the ear canal after instilling the ear drops.
  D) Rinse the child's ear canal with normal saline prior to instilling the ear drops.

Question 2

A patient has been receiving bethanechol (Urecholine) for 1 week. One hour after the dose is administered, he develops sweating, flushing, abdominal cramps, and nausea. What is the rationale for the development of these symptoms?
 
  A) Myasthenic crisis
  B) Cholinergic overdose
  C) Anaphylactic reaction
  D) Pulmonary edema

[Jody Vaughn]

Answer to Question 1

C
Feedback:
The proper administration of ear drops requires tilting the head toward the opposite shoulder, pulling the superior aspect of the auricle upward, and instilling the ear drops into the ear canal. The patient should then lie on the side opposite the side of administration for 20 minutes. To maximize medication absorption, the patient should have a cotton ball placed in the ear canal. Supine positioning is not used, and the ear canal does not need to be rinsed prior to drug administration.

Answer to Question 2

B
Feedback:
A patient who suffers cholinergic overdose will experience sweating, flushing, abdominal cramps, and nausea. An accurate diagnosis may be determined from timing in relation to medication. Signs and symptoms having an onset within approximately 1 hour after a dose of anticholinesterase drug are likely to be caused by cholinergic crisis. Signs and symptoms beginning 3 hours or more after a drug dose are more likely to be caused by myasthenic crisis. These symptoms are not the result of anaphylaxis or pulmonary edema.

[brutforce]

TYSM

[ricroger]

Excellent