Which instructions would be appropriate for the nurse to give to a client with acute conjunctivitis ...

1. You should wash your hands before cleansing the eye and giving eyedrops.
3. You can soak your lids with warm saline to soften crusts and exudates.
4. You should not share towels, make-up, or contact lens with anyone else.

Rationale:
Prevention of cross-contamination by handwashing (hand hygiene) will minimize the risk of bringing in other organisms to an already infected eye. This action should be encouraged at all times, but especially when there already is an infection present. Soaking the lids with sterile saline will soften the crusts from exudates that accompany the Staphylococcus infection and should be included in the instructions. Sharing supplies, such as towels, make-up, or contacts, is never a good idea due to potential for cross-contamination from person to person. But during an actual infection, instructions should include discouragement of using the same equipment after the infection is cleared. Towels need to be washed in hot water. Make-up and contacts should be discarded and not reused. Therefore, this action should be included in instructions. The action of rubbing one's eyes can traumatize the eyes further and should not be encouraged. Soaking or rinsing the eyes with sterile saline or moisturizing solutions will assist in the process. Rubbing also brings the risk of cross-contamination from other sources, including the other eye if only one eye is involved. This action is inappropriate, and should not be included in care.