ASSISTING IN MOUTH CARE/OFFERING MOUTHWASH; EYE INSTILLATION; EYE IRRIGATION; EAR IRRIGATION; NASAL IRRIGATION; NASAL ADMINISTRATION

sitting position

Conscious Patient:

• Assist patient to a ______

hyperextend

Conscious patient:

• Do not let patient ______ his neck when gargling especially if he has poor mouth control

supine with head tilted to one side

Unconscious Patient!

• Position patient ______

padded tongue depressors

Unconscious Patient:

• Dip a _______ into the solution. Use the ______ to clean the patient’s mouth

Ear instillation

introduction of otic medication into the ear.

side-lying position with ear to be treated facing up, or client may sit on chair at the bedside.

Ear instillation:

• Have the client assume

affected side

Ear Instillation:

• Place the patient’s towel on the shoulder of his

gently pull the pinna up and back; in children age 3 or less

Ear Instillation:

• For adults, , pull the pinna down and back.

pull the pinna down and back

Ear Instillation:

• For children age 3 or less

Do not insert the applicator into the ear canal

Ear Instillation:

• If cerumen or drainage occludes outermost portion of ear canal, wipe out gently with cotton tipped applicator.

1 cm (1/2 inch)

Ear Instillation:

• Instill prescribed drops holding dropper _____ above ear canal. To avoid patient discomfort , aim the dropper so that the drops fall against the sides of the ear canal.

5-10 minutes; tragus

Ear Instillation:

• Ask client to remain in position for ____. Apply pressure to ____ of ear with finger.

comfortable

Ear Instillation:

• Assist client in a _____ position after drops are absorbed. Remove gloves, dispose soiled supplies and wash hands.

Eye instillation

the introduction of ophthalmic fluid or topical ointment into the cavity of the eye for a specific length of time.

supine or sit back on a chair with neck slightly hyperextended

Eye Instillation:

• Position the patient

affected side

Eye Instillation:

• Place a towel under the patient’s chin, on the

apply pressure to lower bony orbit and bony prominence beneath the eyebrow.

Eye Instillation:

• With the non-dominant hand, get 1 dry cotton ball then gently retract upper and lower eyelids to expose the conjunctival sac. To hold lids open,

1 to 2 cm (1/2 to ¾ inch)

Eye Instillation:

• With your dominant hand, hold filled dropper with the ophthalmic medication approximately ___ above conjunctival sac

conjunctival sac

Eye Instillation:

• Drop prescribed number of medication drops into the ____

nasolacrimal duct; 30-60 seconds

Eye Instillation:

• Apply gentle pressure to the patient’s _____ with the cotton ball for _____

Conjunctival Sac; apply pressure to lower bony orbit and bony prominence beneath the eyebrow.

Eye Ointment Instillation:

With the non-dominant finger, get 1 dry cotton ball then gently retract upper and lower eyelids to expose the ____. To hold the lids open, _____

conjunctiva from inner to outer canthus

Eye Ointment Instillation:

• With your dominant hand, hold the ointment tube above the lid margin, and apply thin stream of ointment evenly on the _________. Make sure not to touch the opening of the tube with the patient’s eyelid.

affected eye

Eye Ointment Instillation:

• If the patient has an eye patch, apply a clean one by placing it over the ______ so entire eye is covered. Secure with a tape without applying pressure to the eye.

Eye irrigation

is the washing out of the body cavity of the eye by using a stream of water or other fluid.

upright / Fowler’s position

Eye Irrigation:

• Position the patient _____

inner to outer canthus

Eye Irrigation:

• With a dry cotton ball moistened in normal saline solution, gently clean the eyelid margins from _______, and eyelashes from inner to outer side. Throw the cotton ball into the waste receptacle.

1 inch or 2.5 cm from inner canthus

Eye Irrigation:

• With your dominant hand, aspirate irrigating fluid using the sterile syringe. Then hold the irrigating syringe approximately _____

apply pressure to lower bony orbit and bony prominence beneath eyebrow

Eye Irrigation:

• With the non-dominant gloved hand, get 1 dry cotton ball then gently retract upper and lower eyelids to expose the conjunctival sac. To hold the lid open, ______. Do not apply pressure over the eye.

look up; lower conjunctival sac to the outer canthus

Eye Irrigation:

• Ask the patient to _____. Gently irrigate with steady stream toward the ______

periodically

Eye Irrigation:

• Allow patient to close his / her eye _____.

NASAL INSTILLATION

procedure of administering medications by spray or drops into the nasal cavity.

blow his or her nose; cotton applicator

Nasal Instillation

• Provide the patient with tissue wipes and ask the patient to ____. If unable to do so, use the _____ to clean the nose.

ethmoid and sphenoid sinuses

Proetz position

Proetz Position

ethmoid and sphenoid sinuses

maxillary and frontal sinuses

Parkinson’s position

one-third of an inch

Nasal Irrigation:

• Hold up the tip of the nose and place the dropper or the medication nozzle just inside the nares about ____.

5-10 minutes

Nasal Irrigation:

• Have the patient remain in position with head tilted back for ____

upright position with the head forward

Nasal Administration:

• Assist the patient in an _____(do not hyperextend)

inhale gently

Nasal Administration:

• Instruct the patient to _____ through the nose as the spray is being administered.

one nostril closed

Nasal Administration:

• Have the patient hold ____. If the spray is indicated for only one nares, close the nostril that will not receive the medication