Instillation Route

Instillations are liquid medications that are administered to the eyes and ears as drops, ointment, or sprays. You'll need to take special precautions when administering an instillation to prevent spreading the disease.

Here's what you need to do to administer installations in the eye:

• Check the prescriber's order.

• Wash hands and then apply clean gloves. You don't need sterile gloves.

• Position the patient so that the patient is looking toward the ceiling.

• Gently pull down the skin below the infected eye to expose the conjunctival sac.

• If eye drops, o Administer the prescribed number of drops into the center of the conjunctival sac.

o Don't touch the eyelids or the eye lashes with the dropper. o Release the skin and gently press the lacrimal duct (inner corner of the eye) with sterile cotton balls or tissues for 1-2 minutes. This prevents the systemic absorption of the medication through the lacrimal canal.

• If eye ointment, o Squeeze about a half-inch of ointment onto the conjunctival sac. o Tell the patient that he or she might experience blurred vision temporarily.

• Instruct the patient to keep his or her eyes closed for 1-2 minutes.

• Avoid placing medication on the cornea since this can cause discomfort and possibly damage the cornea.

Here's what you need to do to administer eardrops:

• Check the prescriber's order.

• Wash hands and then apply clean gloves.

• Make sure the medication is at room temperature.

• Position the patient so his or her head is tilted slightly toward the unaffected side.

• Straighten the external ear canal by pulling the auricle up and back for a patient who is 3 years of age and older and down and back for a patient under three years of age. (Hint: Children are shorter than adults, so you pull down.)

• Instill the prescribed number of drops into the ear.

• Don't touch the ear with the dropper; the dropper will become contaminated.

• The patient should remain with his or her head tilted for 2-3 minutes.

When administering nose drops and sprays:

• Check the prescriber's order.

• Ask the patient to blow his or her nose.

o Position the patient's head back if the infection is in the frontal sinus. o Position the patient's head to the affected side if the infection is in the ethmoid sinus. o Administer the prescribed number of drops.

o tilt the patient's head backwards for five minutes after administering drops.

• For nose sprays, o Tell the patient to close the unaffected nostril. o Ask the patient to tilt his or her head to the side of the closed nostril. o Spray the medication.

o Ask the patient to hold his or her breath or open the closed nostril and breathe through it per the medication instructions.

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