515257129-EYE-IRRIGATION by Dr.Raafat .pptx

Nursing College

1. DEFINATION Washing of the eye externally using stream of water or other medicated fluids . PURPOSES To clean the eye. To remove foreign particles, excessive secretion or discharge. To apply heat or cold. To reduce inflammation . To relieve discomfort.

2. ARTICLES NEEDED Eye irrigator (undine) / syringe without needle. Large cotton swabs . Mackintosh . K-basin-2 Irrigating solution (sterile) PROCEDURE

3. PROCEDURE Nursing action Rationale 1.Identify the patient and provide explanation as to what will be done and how he may cooperate. Provide for performance of procedure on correct patient. decreases patient’s anxiety and promotes cooperation. 2. Assemble articles at the bedside . Facilitates orderly performance of procedure. 3. Wash and dry hands .

4. 4.Expose the lower conjunctival sac by separating the lids with the thumb and forefinger . Exert pressure on the bony prominence of the cheek bone and on the eye brow when holding the eyelids . 5. Hold the filled eye irrigator about 2.5 cm (1inch) above the eye. Ensures an even ,safe pressure of the solution and avoids possible injury to cornea.

5. 6. Irrigate the eye directing the solution on the lower conjunctival sac, from inner canthus to the outer canthus . 7. Irrigate until the solution leaving the eye is clear (or) until all the solution has been used . 8. Dry around the eye with cotton swabs. Directing the solution in this way prevents fluid from flowing down the nasolacrimal duct . Prevents infection.

6. 9. Apply ointment if prescribed by physician. 10. Discard the irrigated fluid and swabs and sterilize and replace all the reusable articles . Wash hands. 11. Record the treatment showing amount and color of discharge , consistency of discharge, Aids in healing and prevents infection. Prevents transmission of micro-organisms. Serves as a legal documents.

7. Cont,.... Presence of redness and swelling ,and treatment given. 12. Refer the patient to the physician if the eyes show evidence of ulceration. Prevents complication.

8. EAR IRRIGATION

9. PERFORMING EAR IRRAGATION DEFINiTION An ear irrigation is the washing of the external auditory canal with a stream of liquid. PURPOSES To remove the earwax. To remove foreign bodies (except hygroscopic substances). To cleanse the ear in case of purulent discharge caused by middle ear infection.

10. 4. For antiseptic effect. 5. To apply heat. 6. To evaluate vestibular functions (e.g. Bithermal calorie test). SOLUTIONS USED Boric acid 2-4% Sodium bicarbonate solution 1% Normal saline. Hydrogen peroxide 2% Sterile water

11. ARTICLES Prescribed sterile irrigating solution (warmed to 37 degree centigrade). Irrigation set ( container and irrigating bulb syringe ). Waterproof pad. Emesis basin. Cotton tipped applicators. Clean gloves. Cotton balls. Spot light and head mirror. Sterile gauze piece. Sterile jug with extra fluid.

12. PROCEDURE Nursing action Explain the procedure to the patient and inform him how he has to cooperate. Bring equipment to the patient’s bedside. Click the physician’s order, protect the patient and bed linen with a moisture proof pad. Rationale Explanation facilitates cooperation and provides reassurance . Provides for an organised approach to the task.

13. 3. Wash hands 4. Have the patient sit up or lie with the head tilted toward the side of the affected ear. Have the patient support the basin under the ear to receive the irrigating solution. 5. Clean the pinna and meatus at the auditory canal as necessary with moistened cotton-tipped applicators dipped in Prevents spread of micro-organisms. Gravity causes the irrigating solution to flow from the ear to the basin. Materials lodged on the pinna and at the meatus may be washed into the ear.

14. Contd.... 6. Ascertain whether impaction is due to foreign hygroscopic (attracts or absorbs moisture ) body before proceeding. 7. Fill the bulb syringe with warm solution , if an irrigating container is used , allow air to escape from the tubing . If water contracts such a substance it may cause it to swell and produce intense pain. Air forced into the ear canal is noisy and therefore unpleasant for the patient.

15. Contd.... 8. Straighten the auditory canal by pulling the pinna up and back for an adult , upward and back for a child over 3 years of age and down and back for an infant or child up to 3 years of age. 9. Direct a steady, slow stream of solution against the roof of the auditory canal , using only sufficient force to remove Straightening the ear canal helps to allow the solution to reach all areas of the ear canal. Directing solution at the roof of the canal helps prevent injury to the tympanic membrane. Continuous in and out of

16. Contd..... Secretions . Do not occlude the auditory canal with the irrigating nozzle. Allow the solution to flow out unimpeded. 10. When the irrigation is completed, place a cotton ball loosely in the auditory meatus and have the patient lie on the side of the affected ear on a towel or absorbent pad. Of the irrigatin g solution helps to prevent pressure in the canal. The cotton ball absorbs excess fluid and gravity allows the remaining solution in the canal to escape from the ear.

17. contd.... 11. Discard the irrigated fluid and swabs . Clean and replace reusable articles. 12. Wash hands. 13. Record the irrigation, appearance of the drainage and the patient’s response . 14. Remove the cotton ball and assess drainage after 15 minutes. Prevents spread of micro-organisms. Acts as a communication between staff members. Drainage or pain may indicate injury to the tympanic membrane.

18. SPECIAL CONSIDERATIONS Irrigation solution should be at least at room temperature . An irrigating container with tubing and an ear tip may be used if the purpose of the irrigation is to apply heat to the area. If irrigation does not dislodge the wax, instill several drops of prescribed glycerin, carbonide peroxide or other solutions as directed , two or three times daily for 2-3 days which helps to soften and loosen impaction .

19. 4. Take special care to irrigate an older adult’s ears with cool water because dizziness may occur.