Administration of Medications into Eye and Ear- Topical Application

Administration of Medications into Eye and Ear
Presented by Ganga Tiwari ( BSc. Nursing Fourth Year, TU, IOM, Maharajgunj Nursing Campus Kathamandu Nepal)

1. Administration of Medication into Eye and Ear Presented by: Ganga Tiwari BSc Nursing 4 th year, Teaching Learning TU, IOM, Maharagunj Nursing Campus, Kathmandu

2. Contents Administration of medication into the eye Definition Purposes Article required P rocedure 2

3. Contents… Administration of medication into the Ear Definition Purposes Article required P rocedure 3

4. Topical medication When a drug is applied directly most often to intact skin and mucous membrane, it is called a topical medication. Topically means when the action is desired in a localized surface area. They come in the form of lotions, pastes or ointments 4

5. Local instillation of medication An instillation is the administration of liquid medication by drop. This method is used for administration of liquid medication into eye, ear and nose 5

6. Instillation of medication into the Eye It is the method of administering medication inside the eye by instillation. Medication may be in the form of drop or ointments. 6

7. Instillation of eye medication 7

8. Articles required Medication tray containing: Cadrex Medication Disposable gloves Sterile cotton ball soaked in normal saline Dry cotton balls Dry dressing pad and paper tapes Kidney tray 8

9. Procedure Check medication order for preparation, strength of medication, number of drops, Frequency of instillation of medication and eye to be treated. Assemble all the necessary articles. Perform 3 checks and 10 rights. Identify the patient and assess for allergy to medication, lesions, exudates, erythema, location and nature of discharge 9

10. Procedure.. Explain procedure to the patient. Assist the patient to a comfortable position sitting or lying with head slightly hyperextended. Obtain assistance for immobilization in case of young children. Wash hands. 10

11. Procedure.. Wear gloves. Clean the eyelid and lashes with a sterile moistened cotton ball, wipe from inner canthus to outer canthus. Discard cotton ball after each wipes. Instruct the patient to look up ceilings. This action retracts sensitive cornea up and away from conjunctival sac and reduces stimulation of blink reflex. 11

12. Procedure.. Expose the conjunctival sac by placing thumb or fingers of your non-dominant hand just below the eye on the zygmotic arch and gently draw the skin on the cheek 12

13. For liquid medication Approach the eye from side and instill the correct number of drops in the center of the lower lid holding dropper 1-2 cm above the eye. - If patient blinks or closes eyes or if drop lands on outer lid margins, repeat the preparation. 13

14. Procedure.. A fter instilling drops, ask the patient to close eye gently. Instruct the patient to press on nasolacrimal duct for 30 to 60 seconds after instilling liquid medication. 14

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16. For ointments Hold the tube above the conjunctival sac squeeze ointment in lower conjunctiva, from inner canthus to outwards. Instruct the patient to close eyelid and not to squeeze them. Clean the eyelid as needed by wiping from inner canthus to outer canthus. 16

17. Procedure.. Have patient close the eye and roll eye behind closed eyelid. Further distributes medications without traumatizing eye. Apply an eye pad if required and secure it with tape and to instruct the patient not to rub the eye. 17

18. Procedure.. Assess the patient’s response. Replace the medication. Wash hands Document the administration of medications. 18

19. Points to remember One drop is enough. Conjunctival sac normally hold 1 to 2 drops. If more than one drop is ordered, wait 5 minutes in between each medication. Instruct the patient about safety precautions if drops are prescribed for dilatation of pupils 19

20. Contd.. If medication needs to be instilled into both eyes, place in unaffected eye first. Avoid instilling any form of medication directly into the cornea. Avoid touching the eyelids or other eye structure with eye drops or ointments tubes. Use eye medications only for the patient’s affected eye. Never allow the patient to use another patients’ eye medication. 20

21. Administration of medication in Ear It is method of administering ear drops into the auditory canal of ear to produce local effect. Medicine instilled is absorbed through the skin of ear canal and membrane of the ear drum 21

22. Instillation of medication in ear 22

23. Instillation of medication in ear 23

24. Purposes To soften the ear wax To reduce the localized inflammation. To reduce the infection. To clean the ear . To facilitate removal of foreign body. To kill an insect lodge in the ear. To anesthetize 24

25. Contraindications Ruptured tympanic membranes. 25

26. Contraindications Ruptured tympanic membranes. 26

27. Articles required Mediation tray containing: Medication bottle with dropper Disposable gloves Cotton tipped applicator Cotton balls Bowel with normal saline Kidney tray 27

28. Procedure Check drug order in cardex . Asses for allergy to medication, type and amount of discharge, complain of discomfort, ability to co -operate during procedure. Perform three checks and ten rights. Identify the patient and explain procedure, the purpose of medication and position to assume during and after instillation. 28

29. Procedure.. Obtain assistance in case of infants and children to immobilize them. Assist the patient to side lying with ear being treated, uppermost. Clean meatus of ear canal, using cotton tipped applicator if necessary 29

30. Procedure.. Warm the container in hand or by placing it for short period in warm water. The temperature of ear drop should not be lower than body temperature. Straighten the auditory canal. For infants or children less than 3 years, pull pinna down and back. For and adult and children older than 3 years pull pinna upward and back. 30

31. Procedure.. Instill correct number of drops alongside of ear canal by holding the dropper 1 cm above the ear canal. Press gently and firmly a few times on tragus of ear. Instruct patient to remain in side lying position for about 2- 3 minutes. Plug the ear with cotton loosely at the meatus of the auditory canal for 15 to 20 minutes. Do not press the cotton balls into the canal 31

32. Any queries???? 32

33. Questions?? 1 . What are the purposes of instillation of medication into eyes? 2 .What are the articles required for instilling medication in eyes? 3.What are the purposes of administration of medication into the ear? 4 . how can you instill ear drop into the ear? 33

34. References Health learning material center. Institute of medicine of medicine , Tribhuwan University.Fundamentals of nursing ( second edition reprint ,2010). Kathmandu:Heidal Press , Dillibazar . Basvanthappa,B.T . (2004 ). Fundamentals of Nursing. New Delhi : Jaypee Brothers. Perry, A.G. and Potter, P.A. (2007).Basic Nursing Essentials For Practice .(sixth edition): Mosby Giri , M. and Sharma,P . (2013). Essential Fundamental Of Nursing.(first edition).Kathmandu: Medhavi Publication . 34

35. Pathak , S.and Devkota ,R.(2011).A Textbook Of Fundamentals of Nursing.(second edition). Kathmandu:Vidyarthi Prakashan . Taylor,C.R . and Lillis,C .(2008). Fundamental Of Nursing.(Volume1):Lippincott William and Willikins Skidmere ,L . Nursing Drug Reference(2009): Mosby 35

36. THANK YOU!!! 36