Page 1984 - Saunders Comprehensive Review For NCLEX-RN

5. Monitor weight.
6. Maintain oral hygiene.
7. Monitor for side effects such as lethargy, anorexia,
drowsiness, polyuria, nausea, and vomiting.
8. Monitor electrolyte levels for hypokalemia.
9. Increase fluid intake unless contraindicated.
10. Advise the client to avoid prolonged exposure to
sunlight.
11. Encourage the use of artificial tears for dry eyes.
12. Instruct the client not to discontinue the medication
abruptly.
13. Instruct the client to avoid hazardous activities while
vision is impaired.
14. Teach the client not to wear contact lenses during or
within 15 minutes of instilling these medications.
X. Ocusert System
A. Description
1. A thin eye wafer (disk) is impregnated with a time-
release dose of pilocarpine.
2. The Ocusert system was devised to overcome the need
for frequent instillation of pilocarpine.
3. It is placed in the upper or lower cul-de-sac of the eye.
4. The pilocarpine is released over 1 week.
5. The disk is replaced every 7 days.
6. Drawbacks of its use include sudden leakage of
pilocarpine, migration of the system over the cornea,
and unnoticed loss of the system.

B. Interventions

1. Assess the client’s ability to insert the medication disk.
2. Store the medication in the refrigerator.
3. Instruct the client to discard damaged or contaminated
disks.
4. Inform the client that temporary stinging is expected
but to notify the PHCP if blurred vision or brow pain
occurs.
5. Instruct the client to check for the presence of the disk
in the upper or lower cul-de-sac daily at bedtime and
on arising.
6. Because vision may change in the first few hours after
the eye system is inserted, instruct the client to
replace the disk at bedtime.
XI. Osmotic Medications
A. Description
1. Osmotic medications lower intraocular pressure; an
example is mannitol.
2. They are used in emergency treatment of glaucoma
and are used preoperatively and postoperatively to

1984