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7/25/2019 Administering Otic Instillations
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ADMINISTERING OTIC INSTILLATIONS
PURPOSE To soften earwax so that it can be readily removed at a later time To provide local therapy to reduce inammation, destroy infective organisms in the external ear
canal, or both To relieve pain
ASSESSMENTIn addition to the assessment performed by the nurse related to the administration of any medications, priorto applying otic medications, assess:
Appearance of the pinna of the ear and meatus for signs of redness and abrasions Type and amount of any discharge.
etermine if assessment data inuence administration of the medication !i.e., is it appropriate to administerthe medication or does the medication need to be held and the primary care provider noti"ed#$.
PLANNING
Delegationue to the need for assessment, interpretation of client status, and use of sterile techni%ue, otic medicationadministration is not delegated to &A'.
Equipment
(lient)s *A+ or computer printout (lean gloves (ottontipped applicator (orrect medication bottle with a dropper -lexible rubber tip !optional$ for the end of the dropper, which prevents inury from sudden motion,
for example, by a disoriented client (otton u/
For irrigation, a! *oistureresistant towel 0asin !e.g., emesis basin$ Irrigating solution at the appropriate temperature, about 122 m3 !45 o6$ or as ordered (ontainer for the irrigating solution 7yringe !rubber bulb or Asepto syringe is fre%uently used$
IMPLEMENTATION
Preparation4. (hec8 the *A+.
(hec8 the *A+ for the drug name,
strength, number of drops, andprescribed fre%uency.
(hec8 client allergy status. If the *A+ is unclear or pertinent
information is missing, compare it
with the most recent primary careprovider)s written order.
+eport any discrepancies to thecharge nurse or primary care
provider, as agency policydictates.
9. now the reason why the client isreceiving the medication, the drugclassi"cation, contraindications, usual
dose range, side e/ects, and nursingconsiderations for administering and
evaluating the intended outcomes ofthe medication.
Per"orman#e4. (ompare the label on the medication
container with the medication recordand chec8 the expiration date.
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9. If necessary, calculate the medication
dosage.;. . (lean the pinna of the ear and the
meatus of the ear canal. Apply gloves if infection is
suspected. &se cottontipped applicators and
solution to wipe the pinna and
auditory meatus. +ationale: Thisremoves anydischarge present
before the instillation so that it will
not bewashed into the ear canal.
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+ationale: Pressing on the tragus
assists the owof medication intothe ear canal.
As8 the client to remain in the
sidelying position for about 1minutes. +ationale: This prevents
the drops fromescapingand
allows the medication to reach allsides of thecanal cavity.
$ariation! Ear Irrigation
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B. +emove and discard gloves. 'erform hand hygiene.
42. Assess the client)s response and the
character and amount of discharge,appearance of the canal, discomfort,and so on, immediately after the
instillation and again when the
medication is expected to act. Inspectthe cotton ball for any drainage.
44. ocument all nursing assessments and
interventions relative to the procedure.Include the name of the drug or
irrigating solution, the strength, thenumber of drops if a li%uid medication,
the time, and the response of theclient.
E$ALUATION 'erform followup based on
"ndings of the e/ectiveness of theadministration or outcomes that
deviated from expected or normalfor the client. +elate "ndings to
previous data if available. +eport signi"cant deviations from
normal to the primary care
provider.INFANTS%C&ILDREN
Cbtain assistance to immobili6e aninfant or young child. This
prevents accidental inury due tosudden movement during the
procedure. 0ecause in infants and children
under ; years of age, the ear canal
is directed upward, to administermedication, gently pull the pinna
down and bac8. -or a child olderthan ; years of age, pull the pinna
upward and bac8ward.
Ot'er #omment(!DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD
Name o" Stuent Signature Date
(linical InstructorA((e((or)( Name Po(ition Signature Date