Question

Skill name:: Administering Ear medication

All questions must be answered based on the skill listed above:

what is the Description of this skill?

what are the indicators?

what are the nursing interventions (pre, intra, post)?

what are the outcomes/evaluation?

what is the client education for this skill?

what are the potential complications?

what are the nursing interventions?

Answer 1

Administering Ear medication

An ear instillation is a solution of topical medicine prepared for administration into the ear canal. Medicine instilled into the ear is absorbed through the skin of the ear canal and membranes of the eardrum.

Description

To instill eardrops, have the patient lie on his or her side with the affected ear up. Gently pull the lobe of the ear up and back to open the ear canal (down and back for children under the age of three). Hold the medicine dropper just above the entrance to the ear canal and squeeze out the correct number of drops. Release the ear and have the patient remain still for five minutes to allow absorption of the eardrops. Repeat the procedure on the other ear if ordered.

Indicators:

Ear instillations are used primarily to treat wax build-up and inflammations or infections of the ear.

Nursing intervention:

Before the procedure:

• The hands should be washed before administering ear drops.
• Check room for additional precautions.
• Introduce yourself to patient.
• Confirm patient ID using two patient identifiers (e.g., name and date of birth).
• Check allergy band for any allergies.
• Complete necessary focused assessments and/or vital signs, and document on patients records.
• Provide patient education as necessary.
• Plan medication administration to avoid disruption:Dispense medication in a quiet area, Avoid conversation with others, Prepare medications for ONE patient at a time.
• Check the medication label each time to avoid medication errors.
• Be sure it is the right medicine, the right dose (strength), the right time, the right person and the right method.
• Look at the expiration date on the label. Do not use outdated medicine.
• Warm the eardrops to body temperature by rolling the bottle in the hands for several minutes before the instillation.

During the procedure:

• Before instilling ear drops, don clean non-sterile gloves.
• Cleanse external ear of any drainage using a warm wet washcloth.
• Position patient with affected ear uppermost, on unaffected side if lying down, or tilt head to side if sitting up.
• Draw up medication into ear dropper, ensuring correct dosage. Do not return excess medication to stock bottle.
• Gently pull ear pinna back and up for an adult.
• Hold dropper tip just above ear canal. Do not touch dropper tip to ear.
• Allow drops to fall on the side of the ear canal. Dropping the drops directly into the canal and onto the tympanic membrane will cause the patient discomfort.
• Release ear pinna and have patient remain in the position for at least 5 minutes.
• Apply gentle pressure to tragus several times. Pressure helps move medication toward tympanic membrane.

Aftercare:

• Have tissues or a warm washcloth available to wipe off residual medicine that may drip out of the ear when the patient sits up.
• A small piece of clean cotton ball may be placed into the outer portion of the ear canal to absorb excess medicine if desired.
• Discard soiled tissues and cotton in a bag that can be closed and discarded.
• Wipe the tip of the ear dropper with a clean tissue and recap the bottle.
• Remove gloves and assist patient to a comfortable and safe position.
• The hands should be washed again after completing the procedure.
• Document as per agency policy. Include date, time, dose, route; which ear the medication was instilled into; and patient’s response to procedure.

Evaluation :

Ear instillations will produce the desired results within a few days. Contact the physician if the patient experiences ear pain at the time of medicine instillation, or if the condition does not improve.

Complications

Excessive use of eardrops can cause irritation and inflammation of the skin and membranes of the ear.

Client education:

• The patient or members of the patient's family can be taught to instill ear medicines in the home setting.
• Ask the patient to follow directions carefully.
• Do not miss doses.
• Ask the patient to store medications out of reach of children.
• Teach the patient to Warm the eardrops to room temperature before instillation. Warming the medication to room temperature minimizes the risk of vertigo and/or nausea from instillation of the eardrops.
• Ask the patient to remain in the lateral position (unaffected side) for a few minutes after instillation which allows the medication to remain in contact with the tissues of the ear canal.
• Ask the patient to report the physician if he/she experiences any discomfort or pain.
• Assess the patients understanding of the procedure.