A nurse is caring for a client who sustained a blunt trauma to the left eye resulting in periorbital contusion. Which nursing intervention should the nurse implement first?

Cold compresses are the priority to minimize swelling and pain in eye contusions. Other options are less immediate or inappropriate for initial care.

Clinical Judgment This question assesses the principles of prioritization and initial management after acute trauma. The immediate goal after blunt trauma around the eye is to prevent further tissue damage and control swelling and pain. A cold compress constricts blood vessels to minimize bleeding and swelling, and slows the transmission of pain signals, making it the most urgent intervention in this situation. A warm compress is used during the subacute phase (usually after 48 hours) to promote blood circulation and absorb bruising; using it initially can actually worsen swelling. Antibiotic eye drops require a doctor's prescription, and infection prevention is not an immediate life threat, so it is a lower priority. Encouraging the patient to keep the affected eye open can cause pain and discomfort and is not an appropriate intervention. Memory Tip: Remember the principles of initial acute trauma management: Rest, Ice, Compression, Elevation. For the eye area, compression and elevation may be limited, but Ice is key. Think "Ice First for Injury." KR vs US: In both Korea and the US, the basic principle (RICE) for managing acute inflammation/swelling is the same. The difference is that US clinical practice tends to place more emphasis on specific education regarding cold compress application time (apply for 15-20 minutes, rest for 1-2 hours) and skin protection (wrapping in a thin cloth).

Clinical Practice Guide When managing patients with blunt trauma around the eye, apply cold compresses wrapped in a clean cloth or ice pack to avoid direct skin contact. Apply for 15-20 minutes, then rest for at least 1-2 hours to prevent frostbite and skin damage. Nurses must simultaneously assess for warning signs that require Notify HCP!: sudden vision loss, double vision, protrusion or sinking of the eye, restricted eye movement, severe headache, vomiting may suggest orbital fracture or intraocular hemorrhage. Caution: In SATA (Select All That Apply) questions, "applying a cold compress to the eye" may appear alongside "covering the eye with a light pressure bandage" as options. Direct pressure on the eye itself is contraindicated and must never be done, especially when eye injury is suspected. Pressure for the purpose of "reducing swelling" is a principle mainly applied to the limbs.