Pharmacology Eye & Ear Meds #3

Question

A 2 year old is prescribed ciprofloxacin otic antibiotics bid for 7 days for otitis externa. Which instruction by the novice nurse would make the charge nurse need to intervene?

Answers

  1. "Do not take this by mouth."
    • Rationale:

      This answer is not correct because reminding the client to not take this otic drop by mouth is correct. Many antibiotics are given by mouth, with liquid preparations so the parent should be reminded to use otic drops in the ear, not by mouth.

  2. "Place drop in ear every 8 hours."
    • Rationale:

      This answer is correct because “bid” is every 12 hours, not every 8 hours. Every 8 hours would be written as “tid”. How often the drop should be given should be very clear. Medical jargon, such as “bid” should never be used with the parents. Telling the parent to use the drop “every 12 hours” then reinforcing by saying “8 a.m. and 8 p.m.,” is even better.

  3. "Have the child lie down with the affected ear up."
    • Rationale:

      This answer is not correct because positioning the client in the lying position with the affected ear up is correct. Having the child lay down will help the child relax and position them better and help the parent position the ear appropriately.

  4. "Warm drops by holding the drop bottle in hand for at least a minute."
    • Rationale:

      This answer is not correct because instructing the client’s parent to “Warm drops by holding the drop bottle in hand for at least a minute” is an appropriate instruction. Cool or cold drops can be very uncomfortable to the ear so warming them helps for comfort, therefore compliance.

Overview

Proper education about ear drop installation is important for the medication and treatment to be effective. Parents need to know how and when to give children medication.

Explanation

Learning Outcomes

Parents of children with ear infections should be properly informed about how and when to instill ear drops. Medical and prescription jargon should be interpreted so the parent understands clearing how to help the child use drops so the infection is quickly cleared. Many antibiotics are given by mouth, with liquid preparations so the parent should be reminded to use otic drops in the ear, not by mouth. How often the drop should be given should be very clear. Medical jargon, such as “bid” should never be used with the parents. Telling the parent to use the drop “every 12 hours” then reinforcing by saying “8 a.m. and 8 p.m.,” is even better. Having the child lay down will help the child relax and position them better and help the parent position the ear appropriately. The drops will be more comfortable if they are warmed by holding the drop bottle in the hands for at least 1 minute.

Test Taking Tip

Most questions are written in the positive form but be very careful to read the question, in case the question wants you to choose when a nurse should be corrected or a charge nurse needs to intervene so you choose the correct answer.

Video Rationale