1. Eye, Ear, Nose and Inhaled Drugs
Chapter 12

2. 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

3. 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

4. Conjunctival Sac

5. 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

6. 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

7. 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

8. 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

9. Ear Medications
Otic:
Pertains to the ear
Otic medications are use to treat ear inflammation and infections and or to soften ear wax (cerumen)

10. 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
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

11. 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

12. 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

13. Nasal Medications (Delegation Guidelines)
What observations to report and record
Redness
Irritation
Drainage
Bleeding
Nasal congestion
Pain
When to report observations

14. Inhaled Medications
Some corticosteroids & bronchodilators are inhaled into the respiratory tract through the mouth
Affect bronchial smooth muscle
Absorption & onset of action are rapid

15. 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

16. 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