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University of Santo Tomas

Espaa Blvd., Sampaloc, Manila

NCM 104 Skills Laboratory

Adult Medication Administration

Eye Instillation
To soothe eye irritation
To dilate or constrict the pupil
To treat eye infection
To provide anesthesia

Some nursing considerations:

Check the doctors order for the number of drops and the eye to be treated (right,
left, or both).
Assess the condition of external eye structures to generate baseline data.
Determine patients allergy to eye medications and to latex since gloves are to be
used in the administration.
Assess patients level of consciousness and ability to follow direction.
Assess patients ability to do self-administration of the drug. If able, teach
patients to do it. If unable, teach the significant others to do it.

Otic or Ear Instillation

To soften ear wax
To relieve pain
To apply local anesthesia
To destroy organism or an insect dislodged in the auditory canal

Some nursing considerations:

The instillation of medication to the ear is a clean procedure, except when the
tympanic membrane is not intact, which in such case, sterile technique is used.
Instill medications that is warm and at room temperature to prevent occurrence of
Use sterile drops and solution in case the eardrum is ruptured.
Avoid forcing any solution into the ear to prevent pressure within the canal during
instillation and subsequent injury to the eardrum.
Check the physicians order for number of drops to instill and ear to receive the

Nasal Instillation
To relieve nasal and sinus congestion
To treat sinus infection

Some nursing considerations:

Nose drops and nasal sprays are usually water soluble because of the danger of
aspiration pneumonia with oil-based solutions.
The administration of nasal medication is not a sterile procedure, but careful
medical asepsis should be practiced because of the proximity and direct
connection between the nose and the sinuses.
Determine which sinus is affected by referring to medical records of the patients.
Check the order of the doctor.
Assess patients history of hypertension, heart disease, diabetes, and
Inspect condition of nose and sinuses. Palpate sinuses for tenderness. Note type
of drainage, if present.

Skin Application
Depending on the type of preparations, the following are purposes of skin
Powder to promote drying of the skin and prevent friction of the skin
Ointment to provide prolonged contact of a medication on skin and to soften
the skin
Creams and oils to lubricate and soften the skin and prevent drying of the skin
Lotion to protect, soften, soothe, and provide relief from itching
Counter-irritant to relieve discomfort
Astringents and alcohol to cool and dry the skin
Liniments to provide relief from tight aching muscles

Some nursing considerations:

Use gloves and applicator when applying topical solutions to protect the nurse
from accidental exposure.
If the patients skin is intact, use clean technique when applying topical solutions.
If the patients have open wound, use sterile technique in application.
Cleanse the area thoroughly with soap and water before applying the solution.
Dry thoroughly too.
Shake solution before using so that active ingredient reaches the skin in desired
Thoroughly massage creams and ointments into intact skin, or if contraindicated,
pat them onto the skin with fingers.

Perry, A. & Potter, P. (2009). Clinical Nursing Skills and Techniques (7 th Edition).