Author Question: A patient with keratitis is to undergo diagnostic testing. What should the nurse anticipate being ... (Read 23 times)

jon_i · **on:** Jun 25, 2018

A patient with keratitis is to undergo diagnostic testing. What should the nurse anticipate being prescribed for this patient?

1. fluorescein staining with slit-lamp exam
2. photoreactive keratectomy
3. computed tomography (CT) scan
4. glycerol test

Question 2

The nurse is reviewing medications prescribed for patients with open-angle glaucoma. Which medication should the nurse question?

1. timolol (Timoptic), beta-adrenergic blocker, for a 60-year-old with congestive heart failure (CHF)
2. dorzolamide (Trusopt), a carbonic anhydrase inhibitor, for a patient with asthma and chronic obstructive pulmonary disease (COPD)
3. acetazolamide (Diamox) for a 20-year-old male
4. brimonidine (Alphagan), an adrenergic agonist, for a healthy 40-year-old

aliotak · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Correct Answer: 1
Keratitis is an inflammation of the cornea that results in scarring. Fluorescein stain with a slit-lamp exam allows visualization of corneal ulcerations, which is a manifestation of keratitis. Photoreactive keratectomy is a procedure using a laser to reshape the cornea and correct refractive errors. A CT scan would be indicated if a foreign body is suspected. A glycerol test is conducted to diagnosis Mnire disease.

Answer to Question 2

Correct Answer: 1
Timolol (Timoptic) is a selected beta-adrenergic blocker that will reduce the intraocular pressure by decreasing production of aqueous humor. Its systemic effects might limit its use for patients with congestive heart failure (CHF). The nurse should question the use of this medication with a patient with CHF. Dorzolamide (Trusopt) lowers intraocular pressure, and is often an adjunctive therapy that removes fluids through kidney filtration. It is a carbonic anhydrase inhibitor that is contraindicated in closed-angle glaucoma, renal disease, and allergy to sulfa, but is indicated for open-angle glaucoma. This order is appropriate for this patient. Acetazolamide (Diamox) is a carbonic anhydrase inhibitor used as an adjunctive therapy to remove fluids through kidney filtration. A healthy 20-year-old would not have contraindications unless allergic to sulfa drugs. This would not be questioned by the nurse. Brimonidine (Alphagan) is based on an epinephrine, sympathomimetic drug action to dilate the pupil and reduce the production of aqueous humor in patients with open-angle glaucoma. This drug is appropriate if no hypertension or cardiac disease is present, such as in a healthy 40-year-old.