A nurse is preparing to administer an ophthalmic medication to a client. Which of the following actions should the nurse plan to take?

Choice A rationale Proper ophthalmic hygiene requires wiping the eyelid from the inner canthus to the outer canthus. This specific direction prevents the introduction of debris or pathogens from the skin and tear duct into the lacrimal system. Moving from the outer to the inner canthus increases the risk of contaminating the eye with microbes or environmental contaminants that typically reside on the surrounding facial skin surfaces or the temporal edge. Choice B rationale Squeezing the eyelids tightly immediately after medication instillation causes the liquid to be expelled from the conjunctival sac. This action significantly reduces the absorption time of the medication and forces the solution out onto the cheek or into the tear ducts. Instead, the patient should be instructed to close their eyes gently or blink normally to allow the medication to distribute evenly across the surface of the eye for optimal therapeutic effect. Choice C rationale The cornea is a highly sensitive and avascular tissue filled with numerous pain receptors. Placing drops directly onto the cornea causes significant discomfort and can trigger a strong blink reflex that expels the medication. Proper technique involves pulling down the lower eyelid to create a small pocket in the conjunctival sac, which safely holds the medication and allows it to absorb through the conjunctiva without causing trauma to the corneal surface. Choice D rationale Applying gentle pressure to the nasolacrimal duct for approximately 1 to 2 minutes after instillation prevents the medication from entering the systemic circulation through the nasal mucosa. This technique, known as punctal occlusion, is essential for medications that could cause systemic side effects, such as beta-blockers. It ensures that the drug remains localized in the ocular area for the maximum duration possible while reducing risk to the rest of the body.