A patient diagnosed with Graves' disease is experiencing worsening exophthalmos and reports difficulty sleeping due to eye irritation. The nurse is planning care to address these symptoms. Which intervention should the nurse prioritize to manage the patient's condition effectively?

A. Encourage increased fluid intake to reduce ocular dryness and irritation. Increasing systemic hydration does not effectively address the localized tissue changes and exposure keratitis associated with Graves' ophthalmopathy. Exophthalmos is caused by the accumulation of glycosaminoglycans and edema in the extraocular muscles. Topical lubricants and protective measures are more effective than systemic fluid intake for ocular comfort. B. Apply warm compresses to the eyes to enhance circulation and reduce inflammation. Warmth can potentially increase localized vasodilation and worsen the periorbital edema and venous congestion. Cool compresses or artificial tears are preferred to soothe the irritation and reduce the burning sensation. Management focuses on decreasing the volume of the retro-orbital contents and protecting the cornea. C. Elevate the head of the bed to reduce periorbital edema and promote comfort during sleep. Gravity-assisted drainage helps minimize the accumulation of fluid in the periorbital tissues during recumbency. Reducing this edema decreases the pressure on the optic nerve and minimizes the protrusion of the globes. This non-invasive intervention directly addresses the anatomical cause of the irritation and nocturnal discomfort. D. Administer atropine eye drops to dilate the pupils and relieve pressure. Atropine causes mydriasis and cycloplegia, which can actually increase intraocular pressure in predisposed individuals and worsen light sensitivity. Dilation does not resolve the mechanical proptosis or the inflammation of the orbital connective tissue. Medical management typically involves corticosteroids or surgery rather than anticholinergic ophthalmic drops.