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Eye, Ear, Nose and Inhaled Drugs Chapter 12 General Rules • • • • Practice hand hygiene Follow Standard Precautions Wear gloves Use only the dropper supplied by the drug manufacturer • Do not let the dropper touch the eye, ear, nose, face or other body part • Use separate bottle or tube for each person Eye Medications • Position the person properly – Supine, Sitting or Fowler’s position – Tilt the head back slightly • Remove eye secretions with saline & gauze, cotton balls or wash cloth – Clean from inner aspect of eye to outer • Give eye drops at room temperature • Do not allow container tip to touch any body part • Apply drops or ointment to the conjunctival sac – Do not apply directly to eye • Have person gently close eye • Use tissue to blot medication that runs out of eye – Do not rub or wipe Conjunctival Sac Ear Medications • Give ear drops at room temperature – If refrigerated this may take up to 30 minutes • Position person in a side-lying position • Remove excessive amounts of cerumen (ear wax) – Use a wet wash cloth Nasal Medications • Explain that the medication may cause a burning or stinging sensation • Position person properly – Nose Drops: • Supine with head over the edge of mattress – Nasal Spray: • Sitting or Fowler’s position • Remind the person not to blow nose after receiving medication Inhaled Medication • Follow manufacturer’s instructions • Give a bronchodilator before giving a corticosteroid • Check inside the inhaler after removing the cap. – Look for & remove foreign matter • Have patient rinse mouth after inhaling a corticosteroid – Prevents fungal infections in mouth • Clean inhaler & spacer after use Eye Medications (Delegation Guidelines) • Before administering medications to the eye, you need the following information: – If more than one eye medication is ordered – How long to wait in between medications • Usually 1-5 minutes – Observations to report: • • • • • Color of sclera Redness Irritation Drainage Pain – When to report observations Ear Medications • Otic: – Pertains to the ear • Otic medications are use to treat ear inflammation and infections and or to soften ear wax (cerumen) Ear Medications (Delegation Guidelines) • Before administering medications to the ear, you need the following information: – How long to wait before instilling ear drops in other ear • Usually 5-10 minutes – How long to remain in the side-ling position after receiving ear drops • Usually 5-10 minutes – If you need to insert a cotton pledget or plug into the ear • If yes, how long should it remain (usually 15 minutes) – What observations to report: • • • • Redness Irritation Drainage Pain – When to report observations Abbreviations • AD: Right Ear • AS: Left Ear • AU: Both Ears • If you can see excess ear wax, remove it with a wet wash cloth. – Do not insert cotton swabs or cotton-tipped applicator into the ear Nasal Medications (Delegation Guidelines) • Before administering medications to the nose, you need the following information: – Have the patient blow nose – Positioning • Can the patient be positioned with head over the edge of the mattress – Duration that patient needs to remain in supine position after medicating • Usually 5 minutes – How long patient must wait to blow nose after medication Nasal Medications (Delegation Guidelines) – What observations to report and record • • • • • • Redness Irritation Drainage Bleeding Nasal congestion Pain – When to report observations Inhaled Medications • Some corticosteroids & bronchodilators are inhaled into the respiratory tract through the mouth – Affect bronchial smooth muscle – Absorption & onset of action are rapid Metered-Dose Inhalers • Metered-Dose Inhalers (MDI): – Small pressurized canister that contain a spray, mist of fine powder – Measured (metered) amount of drug is released for inhalation each time the dispensing valve is pushed or squeezed • Spacer: – Tube that attaches to the inhaler – Traps of holds the dose sprayed by the MDI • Allows the patient to inhale more slowly & completely Inhaled Medications (Delegation Guidelines) • Before administering an inhaled medication, you need the following information: – Can the person use the MDI themselves – How many times to shake the canister • Usually 4-5 times – Can the person hold their breath for 10 seconds – How long to wait if a repeat puff is needed – How long to wait if there is a second inhaled drug • Usually 1-3 minutes – Do you need to measure the amount of medication remaining in canister – What observations to report & record – When to report observations