Chapter 6: Non Parenteral Medication Administration
6.5 Instilling Eye, Ear and Nose Medications
Critical Thinking Exercises: Questions, Answers, and Sources / References
- Your patient is due to receive a dose of medication instilled into both ears. You find the ear medication stored in the refrigerator. How should you proceed?
Answer: Hold ear drops in palm of hand for 10 minutes until warm OR fill a cup with warm (not hot) water and set bottle in for approx 10 minutes. Clean ear. With the head tiltled to the side, to administer ear drops to an adult pull pinna back and up; child down and back. Hold dropper about 1 inch from the ear canal being careful not to contaminate the dropper. Drop prescribed number of drops. Apply gentle pressure to the tragus in a way to increase pressure in the ear canal forcing the drops toward the tympanic membrane. If the patient is lying down, follow the same procedure and allow the drops to penetrate the ear canal for a few minutes before rolling the patient over to insert drops into the opposite ear.
Sources:
Lilley, L. L., Rainforth Collins, S., Snyder, J. S., Collins, S., & Swart, B. (2016). Pharmacology for Canadian health care practice (3rd ed.). Toronto, ON: Elsevier Canada.
Perry, A., Potter, P., & Ostendorf, W. (2017). Clinical skills and nursing techniques (9th ed.). St. Louis, MO: Elsevier-Mosby.
2. Your patient is due to receive medication instilled into her right eye, but you notice that her left eye has crusting and discharge. Discuss how you would proceed in this situation.
Answer: Clean both eyes. It is not within the nurse’s scope to diagnose the issue with the left eye. Proceed with eye drops as prescribed and consult prescriber. Drop eye drops onto conjunctiva, not cornea. Ask the patient to open and close eyes several times.
Sources:
Lilley, L. L., Rainforth Collins, S., Snyder, J. S., Collins, S., & Swart, B. (2016). Pharmacology for Canadian health care practice (3rd ed.). Toronto, ON: Elsevier Canada..
Perry, A., Potter, P., & Ostendorf, W. (2017). Clinical skills and nursing techniques (9th ed.). St. Louis, MO: Elsevier-Mosby.
3. You need to teach a patient how to self administer nasal spray for seasonal allergy symptoms. Describe the key points you will discuss with them.
Answer: gently blow nose prior. Sit upright. Insert nasal tip into nostril while closing the opposite nostril. Spray and inhale through open nostril. Repeat on other side. Advise the patient not to blow their nose for several hours to allow the medication to be absorbed.
Sources:
Lilley, L. L., Rainforth Collins, S., Snyder, J. S., Collins, S., & Swart, B. (2016). Pharmacology for Canadian health care practice (3rd ed.). Toronto, ON: Elsevier Canada..
Perry, A., Potter, P., & Ostendorf, W. (2017). Clinical skills and nursing techniques (9th ed.). St. Louis, MO: Elsevier-Mosby.
- The correct positioning of the ear when administering drops to a child is:
a. Pull the pinna up and back (Answer: incorrect. This is the positioning for an adult)
b. Pull the pinna down and back (Answer: correct)
Source: Perry, A., Potter, P., & Ostendorf, W. (2018). Clinical skills and nursing techniques (9th ed.). St. Louis, MO: Elsevier-Mosby.
