A nurse is instructing the caregiver of a toddler who has bacterial conjunctivitis and a new prescription for an ophthalmic ointment. Which of the following instructions should the nurse provide?

Choice A rationale Directing the toddler to look downward actually positions the cornea in the path of the medication application, increasing the risk of irritation or injury. For proper administration of ophthalmic ointment, the patient should be instructed to look upward. This action exposes the lower conjunctival sac and moves the sensitive cornea away from the tip of the tube, ensuring the medication is deposited safely and effectively without causing corneal trauma. Choice B rationale Applying the ointment in a thin line along the lower conjunctival sac is the standard technique for ophthalmic medications. This anatomical space allows the medication to be distributed evenly across the ocular surface as the patient blinks. A thin line is sufficient to achieve therapeutic levels of the antibiotic while minimizing blurred vision. This method ensures the medication contacts the inflamed conjunctiva directly to treat the bacterial infection efficiently while avoiding excessive wastage. Choice C rationale Cleaning secretions from the outer to the inner canthus is incorrect because it risks pushing contaminated material and pathogens into the lacrimal duct and the opposite eye. The correct technique is to wipe from the inner canthus toward the outer canthus. This direction follows the natural flow of tears and moves bacteria away from the nasolacrimal system, thereby preventing the spread of infection and maintaining better ocular hygiene during the treatment. Choice D rationale Using a sterile glove and applicator is unnecessary for the application of ophthalmic ointment and may be cumbersome when treating a toddler. The nurse should instruct the caregiver to wash their hands thoroughly before and after the procedure. The tip of the ointment tube must remain sterile and should not touch the eye or any other surface. Hand hygiene and careful technique are sufficient to prevent cross-contamination without needing specialized sterile equipment.