Intranasal Medication Administration By Candice Laney TCCC Nursing Instructor

Advantages Direct absorption into the bloodstream Intra nasal medications can be absorbed as quickly as IV administered medications Absorption is quicker than subcutaneous or intramuscular routes. Convenient Safe route Painless Does not require sterile tech

Disadvantages Limited medications can be delivered this route. Mucosal health impacts the absorption

Types Spray Drops Tampons

Position for medication administration Spray= sitting Drops= supine with head tilted back Tampon= supine or sitting with head tilted back

Can I delegate this task? No Administering nasal medications should not ever be delegated to assistive personnel.

Assessment Which sinus is affected Client hx of (HTN) hypertension, (CV Disease)heart disease, diabetes or hyperthyroidism Decongestants may produce unwanted side effects, such as excitation of the central nervous system (e.g., insomnia, restlessness, agitation), tachycardia, urinary retention, and elevations in blood pressure Inspect condition of nose, noting TACO Ask questions to assess clients understanding of the nasal instillations and willingness to learn self administration

Implementation Perform hand hygiene Arrange supplies at bedside Apply gloves Instruct client to clear or blow nose (unless contraindicated) Ensure proper positioning of client

Implementation (Positioning) Position patient for drops; supine head tilted back to access posterior pharynx Position patient in a supine position with head tilted over bed or pillow under shoulders to reach the ethmoid or sphenoid sinus. Position patient with head tilted back over edge of bed or pillow under shoulders and tilt head to the side to be treated in order to reach the frontal and maxillary sinus

Implementation Support clients head with non-dominant hand Instruct client to breathe through mouth Hold dropper ½ inch above nares and instill the prescribed number of drops Have client remain in supine position for 5 minutes Offer facial tissue Dispose the soiled tissue and remove gloves and wash hands.

Evaluation Observe client for side effects for 15-30 minutes post instillation Re-inspect condition of nasal passages Ask client to describe risks of overuse Provide education regarding instillation and side effects Ask client to demonstrate self medication

Record and Report Record medication administration on MAR immediately after administration.(Drug name, #of drops, which nostril used, and time of administration) If withheld, record reason, circle time and initial. Record client response Report any unusual adverse effects and notify physician