Installing nasal drops.pptx

installation nasal drop

1. Instilling Nose Drops Presented By Mrs.Usha Rani Kandula , MSc(N), Assistant professor in Adult health nursing, Department of Clinical nursing, Arsi University, College of health sciences, Asella , Ethiopia, Institutional email: [email protected].

2. Nasal Instillations -Nasal instillations can be performed with different preparations: drops or nebulizers (atomizer or aerosol). -Nasal drugs are administered to produce one or more of the following effects: to shrink swollen mucous membranes, to loosen secretions and facilitate drainage, to treat infections of the nasal cavity or sinuses. -Because many of these products are non-prescription drugs, clients should be taught their correct usage.

3. -For example, nasal decongestants are common over-the-counter drugs used to shrink swollen mucous membranes; however, when these drugs mare used in excess, they may have a reverse or rebound effect by increasing nasal congestion. -The nasal sinuses (frontal, ethmoid, maxillary, and sphenoid sinuses) communicate with the nasal fossae and are lined with mucous membranes similar to those that line the nose. -Nose drops can be instilled to remain in the nasal passage, to reach the ethmoid and sphenoid sinuses, or to reach the frontal or maxillary sinuses.

4. - Location is determined by the degree of hyperextension and position of the head during instillation. -Although the nose is considered a clean (not sterile) cavity, because of its connection with the sinuses, the nurse uses medical asepsis when performing nasal instillations. -Nebulizers (inhalers) are used to deliver a fine mist containing medication droplets.

5. The nurse should administer or assist clients with the usage of atomizers and aerosols: • Instruct the client to clear the nostrils by blowing the nose. • Client should be in an upright position with head tilted back slightly.

6. Atomizer • Occlude one nostril to prevent air from entering the nasal cavity and to allow the medication to flow freely in the open nostril. • Insert the atomizer tip into the open nostril and instruct the client to inhale, then squeeze the atomizer once, and instruct the client to exhale.

7. Aerosol • Shake the aerosol well before each use. • Grasp between thumb and index finger and insert the adapter tip into one nostril while occluding the other nostril with a finger, then press the adapter cartridge firmly to release one measured dose of medication. • Repeat the above steps as ordered for the other nostril. • Instruct the client to keep head tilted backward for 2 to 3 minutes and to breathe through the nose while the medication is being absorbed. -When the client is discharged with a nasal inhaler, the nurse should teach the client how to store and use the device.

8. Teach Use of Respiratory Inhalants -Respiratory inhalants are delivered by devices that produce fine droplets that are inhaled deep into the respiratory tract. -These medication droplets are absorbed almost immediately through the alveolar epithelium into the bloodstream. -Oropharyngeal hand-held inhalers deliver medications that produce both local and systemic effects, such as bronchodilators and mucolytics . -Bronchodilators improve airway patency and are used to prevent or treat bronchospasms, asthma, and allergic reactions.

9. - Mucolytics are used to liquify tenacious (thick) bronchial secretions. - There are three types of oropharyngeal hand-held inhalers: metered-dose inhaler, turbo-inhaler, and the nasal inhaler (previously discussed). -Clients must be able to form an airtight seal around the inhaling devices and be able to assemble the turbo inhaler. -This requirement prevents some clients, such as clients with visual or coordination impairments, from using these devices.

10. -Bronchodilators are contraindicated in clients who have a history of tachycardia. -The nurse should ensure that the client knows how to use the inhaler correctly so that the prescribed medication dose is delivered. -A metered-dose inhaler delivers a measured dose of the medication with each push of the canister. -The nurse needs to evaluate the client’s ability to adequately compress the inhaler to deliver a full dose and to inhale at the same time as the dose is expressed.

11. - Failure to do either could prevent the client from receiving the full benefit of the inhaler. -The ability to compress the inhaler for dose delivery can be affected by hand strength (which diminishes with age), flexibility (as in arthritic changes), and disease related to weakness (such as chronic respiratory disease). - Careful discharge instructions and observation of the client performing the task are important to continued therapeutic effect at home (see the accompanying display for home care application).

12. Equipment Medication administration record (MAR) Medication with dropper Emesis basin (optional) Non sterile gloves Tissue

13. Sl.No Action Rationale 1 Check with the client and chart for any known allergies. Prevents the occurrence of hypersensitivity reactions. 2 Check the MAR against health care practitioner’s written order. Ensures accuracy in identification of medication. 3 Wash hands. Reduces transfer of microorganisms. 4 Check client’s identification armband. Accurately identifies client. 5 Explain the procedure to the client and provide privacy. Reduces anxiety and enhances collaboration. 6 Instruct client to blow nose unless contraindicated by client condition (such as recent nosebleed). Removes mucus and secretions that might block medication absorption.

14. Sl.No Action Rationale 7 Explain that the client may feel a burning sensation to the mucosa or a choking sensation, or both, as the drop trickles back into the throat. Understanding what to expect reduces anxiety and enhances cooperation. 8 Place the client in a supine position and hyperextend the neck. -Position the head to the site that facilitates the drops’ reaching the expected site, -as shown in Figure 29-36. Proper position provides access to passages and helps medication reach the appropriate site. 9 Instruct the client to breathe through his or her mouth. Helps prevent aspiration of drops into the lungs. 10 Squeeze some medication into the dropper.

15. Sl.No Action Rationale 11 -Insert the nasal drops about 3/8 inch into nostril, keeping the tip of the dropper away from the sides of the nares. -Instill the prescribed dosage of medication and observe the client for signs of discomfort. Prevents contamination of the dropper. 12 -Instruct the client to remain supine for 5 minutes. Prevents medication from leaking out of the nose prematurely. 13 -Discard any unused medication remaining in the bottle. Prevents contamination of inmedication in the the dropper. 14 -Return the client to a comfortable position and provide the client with the emesis basin and tissue to expectorate any medication that flows into the oro -pharynx and mouth. Restores client comfort.

16. Sl.No Action Rationale 15 Remove gloves and wash hands. Reduces spread of microorganisms. 16 Record on the MAR the drug given, number of drops instilled, and nostril medicated. Provides documentation that the medication was given. 17 Observe the patient for side effects for 30 minutes after administration. Drugs given onto the mucosa can be systemically absorbed, causing an adverse reaction. Thanking you