# A nurse is caring for a client with bacterial conjunctivitis. Which nursing intervention should be implemented first? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=541631 > language: ko > subject: Adult Health ## 문제 A nurse is caring for a client with bacterial conjunctivitis. Which nursing intervention should be implemented first? ## 보기 1. Instruct the client on proper hand hygiene and eye care techniques **✔ 정답** 2. Administer prescribed antibiotic eye drops to both eyes 3. Apply warm compresses to the affected eyes now 4. Obtain a culture of the eye discharge first **정답: 1** ## 해설 Hand hygiene and infection control education is the priority to prevent transmission of bacterial conjunctivitis. Other interventions like antibiotic drops, warm compresses, or cultures are important but secondary to infection control. ## 심화 해설 Clinical Reasoning & Priority Setting For a client with bacterial conjunctivitis, the nurse must prioritize interventions that immediately break the chain of infection and prevent transmission. Bacterial conjunctivitis is highly contagious, and the most critical first step is to ensure the client and family understand and implement strict infection control measures. While diagnostic procedures and comfort measures are important, they do not take precedence over halting the spread of the pathogen. The foundational principle here is the "chain of infection." The infectious agent (bacteria) resides in the reservoir (the infected eye) and exits through the portal of exit (exudate/drainage). The primary mode of transmission is direct contact, often via the hands. By instructing the client on proper hand hygiene and eye care techniques first, the nurse directly interrupts this transmission route. This action protects the client from autoinoculating the other eye and safeguards other individuals, including healthcare staff and family members, from acquiring the infection. This aligns with standard precautions and is a non-invasive, immediate, and independent nursing action that can be implemented without delay. The study by Pandey et al. on ophthalmia neonatorum, a form of neonatal conjunctivitis, reinforces the critical nature of this approach by highlighting the significant prevalence and risk factors associated with conjunctival infections in vulnerable populations [1]. Although focused on neonates, the core epidemiological concern—preventing serious complications and spread—applies across the lifespan. The research underscores that even with medical advances, conjunctival inflammation remains a significant health concern, often linked to lapses in perinatal and postnatal care practices [1]. This directly supports the nursing imperative to prioritize caregiver education on hygiene as the most impactful initial intervention to mitigate risk and prevent the condition from escalating into a more serious outbreak or complication. Other options are secondary or dependent on this first step. Administering antibiotic eye drops (Option 2) is a dependent nursing function requiring a prescription and is not the immediate, independent priority before teaching infection control. Furthermore, drops are typically instilled into the conjunctival sac, not necessarily both eyes unless prescribed prophylactically. Obtaining a culture (Option 4) is a diagnostic step that may be performed, but it does not address the immediate risk of contagion and would logically follow or be concurrent with, not precede, infection control teaching. Applying warm compresses (Option 3) is a comfort measure for removing crusts but does not address the primary safety risk of transmission. References (research sources) - [1]Prevalence, Risk Factors, and Microbial Spectrum of Ophthalmia Neonatorum: A Cross-Sectional Study From Central India.Research articlePandey P, Soni S, Pal V. (2026) · DOI: 10.7759/cureus.109481 ## 임상 시나리오 Bacterial Conjunctivitis: First Priority Nursing ActionImmediate Infection Control to Break Transmission The highest priority for a client with bacterial conjunctivitis is to interrupt the chain of infection. The primary mode of transmission is direct contact with exudate, often via contaminated hands. Instructing on proper hand hygiene and eye care techniques is an immediate, independent nursing action that prevents autoinoculation of the other eye and spread to others. Perform hand hygiene with soap and water or an alcohol-based hand rub before and after any contact with the client or their surroundings. Teach the client to use a separate, clean washcloth and towel and to wash hands immediately after touching the infected eye. This directly addresses the portal of exit and mode of transmission. CautionAdministering antibiotic drops or applying compresses before establishing infection control risks contaminating the medication bottle, linens, and the nurse's hands, facilitating further spread of the highly contagious pathogen. ## 핵심 개념 - **Bacterial Conjunctivitis** — A highly contagious inflammation of the conjunctiva caused by bacteria, characterized by purulent discharge and requiring strict infection control. - **Chain of Infection** — A model describing the six elements needed for an infection to spread: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host. - **Standard Precautions** — The minimum infection prevention practices that apply to all patient care, including hand hygiene, regardless of suspected or confirmed infection status. - **Autoinoculation** — The process by which an infection is spread from one part of the body to another, such as touching an infected eye and then touching the other eye. ## 같은 주제 문제 - [A nurse is assessing a 5-year-old child with suspected bacterial conjunctivitis. 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