detail study of procedures

4. EYE : The eye is the organ of sight. It is situated
in the orbital cavity and supplied by the optic
nerve.
It is almost spherical in shape and about
2.5cm in diameter. The space between the eye
and the orbital cavity is occupied by adipose
tissue. The bony walls of the orbit and the fat
helps to protect the eye from injury.

5. The human eye is an organ that reacts to
light and has several purposes. As a sense
organ, the mammalian eye allow vision.
Rod and cone cells in the retina allow
conscious light perception and vision
including color differentiation and the
perception of depth. The human eye can
distinguish about 10million colors.

7. There are three layers of tissue in the walls of
the eye.
 The outer fibrous layer : sclera and cornea.
The middle vascular layer or uveal tract
consisting of the
choroid
ciliary body
iris.
The inner nervous tissue layer : retina.

8.  The sclera, or white of the eye, forms the
outermost layer of the posterior and lateral
aspects of the eye ball and is continous
anteriorly with transparent cornea.
 It consists of a firm fibrous membrane that
maintains the shape of the eye and gives
attachment to the extrinsic muscles of the eye.
 Anteriorly this sclera continous as a clear
transparent epithelial membrane ,the cornea

9. The ciliary body is the anterior continution
of the choroid consisting of the ciliary
muscles (smooth muscles fibres) and
secretory epithelial cells. As many of the
smooth muscle fibres are circular the ciliary
muscle acts like a sphincter. The lens is
attached to the ciliary body by radiating
suspensory ligaments likes this spokes of a
wheel.

10. The choroid lines the posterior five-sixth’s
of the inner surface of the sclera. It is very
rich in blood vessels and it is deep choclate
brown in colour. Light enters through pupil ,
stimulates the sensory receptors in the retina
and is then absorbed by the choroid.

11. The iris is the visible colour part of the eye and
extents anteriorly from the ciliary body line behind
the cornea and infront of the lens.
It divides the anterior segment of the eye into
anterior and posterior chamber which contain
aqueous fluid secreted by the ciliary body .
It is the circular body composed of pigment cells
and 2 layers of smooth muscle fibers ,one circular
and other radiating in the center is an aperture
called the pupil.

12. The lens is highly elastic circular biconvex body
lying immediately behind the pupil .
It consists of fibres enclosed with in a capsule it
is suspended from the ciliary body by the
suspensory ligament .
Its thickness is controlled by the ciliary muscle .

13. Retina is the inner most layer of the wall of the
eye
It is an extremely delicate structure and is well
adopted for stimulation by light rays.
It is composed of several layers of nerve cell
bodies and their axons, lying on a pigmented
layer of a epithelial cells which attached it to the
choroid .

14. The eye is supplied with arterial blood by the
ciliary arteries and the central retinal artery.
These are branches of the opthalmic artery
one of the branch of internal carotid artery
venous drainage is by a number of veins,
including the central retinal vein, which
eventually empty into a deep venous sinus.

15. Dark Adaptation:-
 When expose to bright light, the rhodopsin with in the
sensitive rods is completely degraded. This doesn’t effect
vision in good light ,when there is an enough to activate the
cones
 However if the individual moves into a darkened area
where the light intensity is insufficient to stimulate the
cones, temporary visual impairment results whilst the
rhodopisn is being regenerated with in the rods “dark
adaptation”. when regeneration of the rhodopsin has
occurrednormalsightreturns.

20. INTRODUCTION:
An irrigation is the washing or flushing of
an area , using a large volume of fluid in order to
cleanse, to apply heat or to apply medications.
Irrigations requried either a clean techinque or a
sterile techinque. Sterile techinque when ever
there is a break in the continity of the skin.

21. DEFINITION : An eye irrigation is the
washing of the conjuctival sac by a liquid.
PURPOSE:
To treat inflammatory process of
conjuctivitis.
To apply medications for an antiseptic effect.
To Remove foreign objects or irritating
chemicals falling in the eyes.
To apply heat or cold to the eyes.

22. Although eye is not a sterile organ it is
better to use a sterile technique when
treating the eye for the fear of introducing
infection into the eye and for the value of
sight.
All the articles and the solutions that come
in contact with the eye should be sterile.
Wash hands thoroughly before and after the
procedure.

23. It is best to treat each eye separately using
separate equipments and solutions to prevent
infections from one eye entering into the other.
Place the head tilted to the effected side so that
it allows drainage away from the unaffected eye.
thus potential contamination of the healthy eye
is prevented.
Before irrigation starts, carefully clean the eye
lips to remove any secretions or particles of dust
adhering to the lashes, which would otherwise
be carried into the conjuctival sac.

24. When both eyes or to be treated, treat the least
infected eye first to minimize changes of
accidentally infecting it by the infection carried
from the badly contaminated eye.
Never direct forceful streams of solutions into the
eye. If the solutions are held very high, it will flow
in great force that might injure the eyes. The
solutions are held to the height which allow a
steady flow of the solutions.
Restrict the movements of the patients when he is
lightly to be un-co-operative.

26. Check the name ,bed number and identification
of the patient.
Check the diagnosis and the purpose for the eye
irrigation.
Check the doctor’s order for specific instructions
regarding type of solution , and the temperature
at which it is to be used.

27. Assess the patients abilities and limitations.
Assess the patients mental state to follow
instructions.
Assess the need for any restraints.
Check the articles available in the patient’s unit.

28. ARTICLES PURPOSE
1.A sterile irrigator
appropriate for irrigation
with sterile solution for
irrigation .Any one of
the following may be
used as an irrigator.
-An undine
-A rubber bulb
syringe
The size of the irrigator
depends upon the amount
of fluid to be used.

29. ARTICLES PURPOSE
-Iv bottle with Iv set
-An irrigating can with tubing
-Amedicine dropper
2.Sterile jug with extra fluid
3.Kidney tray and paper bag
4.Sterile wet swabs in a bowl
5.Sterile cotton balls in a
container.
3.To receive waste
4.To clean the eyes before
the procedure . 5.To dry
the eyes after the
procedure.

30. ARTICLES PURPOSE
6.Mackintosh and towel.
7.Transfer forceps in a
sterile container.
8.Eye dressings and eye
medications ,if ordered
9.Iv stand , if needed
6.To protect the bedding
7.To handle the sterile
articles
9.To adjust the height of
an irrigator.

37. Explain the procedure to the patient to win his
confidence and co-operation.
Explain the sequence of the procedure and tell
him how he can co-operate in the procedure.
Have the patient lying on his back with the head
turned slightly to the side to be irrigated.
If the patient is a child or un-co-operative restrain
the movement to prevent any interference with
the procedure.

38. Protect the patient garments and the bedding with
a mackintosh and a towel.
Arrange the light in a way to provide adequate
light.
Ask the patient if appropriate , to hold the kidney
tray to receive the return flow.
Arrange the articles conveniently in the patient’s
unit.

39. STEPS RATIONALE
1.Wash hands
2. Clean the eyelids and
eye lashes using the wet
swabs . Wipe the lids
from the inner corner of
the eye to the outer corner
using one swab for one
stroke.
1. To prevent cross
infection
2. Cleaning the eyelids
during irrigation helps
to prevent infection and
dust particles carried to
the conjuctiva of the
eye cleaning from the
inner corner to the outer
corner.

40. STEPS RATIONALE
3.Irrigate the eye using an
appropriate irrigator
i. Adjust the flow of liquid
by adjusting the height of
an irrigator and using
clamps for the tubing.
ii. Test the temperature of the
irrigation solution on the
inner aspect of the wrist.
i. If the fluid is directed
forwarded into the eyes, it
can injury the soft tissues
of the eyes.
ii. The fluid should be at high
temperature

41. STEPS RATIONALE
iii. Ask the patient to close
the eyes and allow a small
amount of fluid to run over the
lid.
iv. Hold the eyelids open by
separating the eyelids gently
with the thumb and forefinger
of the left hand when opening
iii. To reassure the patient
that the solution is not very
hot.
iv. If force is exerted on the
eyelids , it can cause spastic
classic of the eye lids and
will make irrigation difficult.

42. STEPS RATIONALE
the eyelids, don’t
supply pressure on the
eyeball but press against
the cheek and eyebrow.
v. Hold the nozzle of the
irrigator about 2cm above the
eyes and allow the fluid to run
into the conjuctival sac.
v. Precaution is taken not to
touch the eye with an
irrigator.

43. STEPS RATIONALE
vi. Direct the flow of fluid from
the inner canthus to the outer
canthus .Ask the patient to look
while irrigating the inner part
of the upper lid is irrigated.
vi. Directing the flow of
fluid from inner canthus to
the outer canthus will
prevent forcing the infection
to the naso-lacrimal duct.
Directing the stream of fluid
to different parts of the
eyeball ensure through
cleaning of the eye.

44. STEPS RATIONALE
vii. Irrigate the eye until the
desired effect is achieved.
viii. Repeat the procedure on
the other side , if necessary
using separate articles and
solutions.

50. Wipe the discharge if any, from the eyelids and
clean thoroughly .
Inspect the eyes for the effect of the irrigation. If
the irrigation was carried out to treat
inflammatory conditions , no pus should be clean
and separate when the procedure is completed.
Instill the eye drops or ointments , if ordered .
Apply dressings if ordered .

51. Take all articles to the utility room , clean and
replace them to their proper places
Wash hands.
Record the procedure on the nurses record with
date and time. Record the solutions used ,
medications instilled , the condition of the eye
before and after the procedure.
Repeat the procedure at the specified interval.

53. DEFINITION:
An instillation is defined as process by
which a liquid medication is introduced into
a cavity drop by drop.
INSTILLATION OF MEDICATIONS
INTO THE EYE:
Medications may be instilled in the form
of eye drops or ointment . The commonly used
eye drops and ointments are:

54. Atropine 1% - to dilate the pupil.
Eserine ½% - to contract the pupil.
Adrenaline 1/1000% -To check bleeding.
Silver nitrate 1 to 2% - as an antiseptic and
especially used in gonococcal infection.
Mercurochrome 1 to 2% - as an antiseptic
Boric acid 2 to 4% - as an antiseptic.
Novocaine and cocaine – as local anaesthetic.
Teramycin and soframycin – as antibiotic.
Betnovate eye ointment – anti infective and anti
inflammatory.

55. PROCEDURE:
 place the patient in a back lying position with the
head hyper extended with a pillow under the
shoulders.
 Ask the patient to look upwards while the nurse
separates the lower lid by pressing it against the
cheek bone.
 The drops are taken in a dropper holding the dropper
from 1 to 2cm above the eye .
 Instill the number of drops in the centre of the lower
lid.
 If ointment is to be applied , apply it from the inner
aspect to the outer aspect.

56. Ask the patient to close the eyelids and move the
eyeballs from side to spread the medications all
over the conjuctiva.
Wipe of the excess medications that remains on
the eye with a clean cotton swab.
The nurse discards a small amount of ointment on
a sterile cotton ball and wipe the top of the tube
before she replaces the cap.

57.  Be certain that you have the right patient , right
medication and the right eye .Check the doctor’s
orders to see what medication is to be instilled in
whicheye.
 Never instill any medication into the eye , unless it is
ordered bythephysician.
 Check the expiry date of the medications. Never apply
anymedicationwiththedateofexpiryalreadyover.
 Neveruseany eyedrops which arediscolored ,cloudy
andprecipitated.

58. Ophthalmic solutions should be sterile and are
prevented from contamination during the
preparation or administration.
Use separate eye droppers for separate
medications.
Neither substitute a solution or medication of one
strength with that of another strength nor substitute
one medication for another , without permission
from the doctor.
Never use any solution or ointment which are
unlabelled to instill in the eye.

60. The ear is the organ of hearing and is
also involved in balance. It is supplied by the
8th cranial nerve i.e the cochlear part of the
vestibulo- cochlear nerve , which is stimulated
by vibrations caused by sound waves.

61. STRUCTURE:- The ear is divided into
three distinct parts
-outer ear
-middle ear
-inner ear
*The outer ear collects the sound waves and
directs them to the middle ear , which in
turn transfers them to the inner ear ,where
they are converted to nerve impulses and
transmitted to the hearing area in the
cerebral cortex.

62. OUTER EAR:
The outer ear consists of the auricle
(pinna) and the external acoustic meatus
(auditory canal).
 AURICLE (PINNA):
The auricle is visible part of the ear that
projects from the side of the head. It is composed
of fibro elastic cartilage covered with skin .It is
deeply grooved and ridged the most prominent
outer ridge is helix.

63. EXTERNAL ACOUSTIC MEATUS
(AUDITORY CANAL)
 This is a slightly ‘s’ shaped tube about 2.5cm long
extending from the auricle to the tympanic
membrane (ear drum).
 The lateral 3rd is cartilaginous and the remainder is a
canal in the temporal bone.
 The meatus is lined with skin continous with that of
the auricle.

64. There are numerous ceruminous glands and hair
follicles , associated with sebaceous glands , in the
skin of the lateral third.
Ceruminous glands are modified sweat glands
that secrete cerumen(ear wax) , a sticky material
containing protective substances including the
enzyme lysozyme and imunoglobulins.

65. This is an irregular shaped air filled cavity with in the
petrous portion of the temporal bone. The cavity , its
contents and the air sacs which open out of it are lined
witheithersquamousorcuboidalepithelium.
 The lateral wall of the middle ear is formed by the
tympanicmembrane.
 Theroofandfloorareformedbythetemporalbone.
 The posterior wall is formed by the temporal bone with
openingsleadingtothemastoidantrum.

66. The medial wall is a thin layer of temporal bone
in which there are two openings:
-oval window
-round window
The oval window is occluded by part of a small
bone called the stapes and the round window, by
a fine sheet of fibrous tissue.
AUDITORY OSSICLES:
These are three very small bones only a
few millimeters in size that extend across the
middle ear from the tympanic membrane to the
oval window.

67. The malleus , this is the lateral hammer shaped
bone.
The incus this is the middle anvil shaped bone.
 The bony articulates with the malleus , the long
process with the stapes.
 The Stapes this is the medial stirrup shaped
bone.

71. DEFINITION: An ear irrigation is the washing
of the external auditory canal with a stream of
liquid.
PURPOSE:
To remove the ear wax .
To remove the foreign bodies.
To cleanse the ear in case of purulent discharges
caused in the middle infection.
For antiseptic affect.
To apply heat.
To evaluate vestibular functions eg: by thermal
caloric test.

72. SOLUTIONS USED:
Boric acid 2 to 4%
Sodium bicarbonate solution 1%
Normal saline
Hydrogen peroxide -2%
Plain water

73. GENERAL INSTRUCTIONS:
Explain the procedure to the patient to win
his confidence and co-operation.
Straighten the external auditory canal by
holding the patient ear upward and
backward in case of adults and pull it
downward and backward.
When irrigating the ear direct the stream of
solution and the wall of external auditory
canal and never approach tympanic
membrane to prevent damage to it which it
cause deafness.

74.  Irrigation should be given with only a minimum
amount of pressure an irrigating can with tubing
is preferred to a syringe because it provides a
continous flow of fluid and the pressure of the
fluid also can be controlled by adjusting the
height of the can and by the application of clamps
the reservoir should not be 6inches or 15cms
above from the level of the ear.
 Watch the patient for the symptoms of vertigo if
this occurs the irrigation should be discontinued.
 Use sterile equipment.
 Always do the procedure in an adequate light.

75. PRELIMINARYASSESSMENT:
Check the name, bed number and other
identification of the patient.
Check the diagnosis and purpose of the ear
irrigation.
Check the doctor’s orders and the specific
instructions regarding the type of solutions
to be used and the movement of the patient.
Assess the patients abilities and limitations.

76.  Assessthepatientmentalstatetofollowtheinstructions.
 Ascertain whether the impaction is due to a hygroscopic
substance which attracts and observes moisture in such
case the ear irrigation should not be carried out because
the substance will observe , water and swell and produce
intensepain.
 Examine the ear for any perforation of the tympanic
membranebyusinganotoscope.
 Checkwhetheroneorbothearsaretobeirrigated.
 Checkthearticlesavailableinthepatient’sunit.

77. ARTICLES PURPOSE
1.A sterile container
appropriate for the
irrigation with the sterile
solution use one of the
following as an irrigator.
i. An irrigating can with
tubing.
ii. A rubber bulb syringe
1.Even though the
auditory canal is not
sterile cavity ,
techniques are used to
prevent introducing
infections into the
middle ear in case of
the perforation of the
tympanic membrane.

78. iii.Ametal syringe
iv. Sterile jug with fluid if
necessary .
v. Kidney tray and paper bag.
vi. Sterile gauze piece or
Cotton balls in a container.
vii. Cotton applicator in a
container.
v .To receive the wastes
vi. To plug the ear at the end
of the procedure to absorb the
infection left in the auditory
canal.
vii. To clean the external
auditory canal and to remove
any discharge

79. ARTICLES PURPOSE
viii. Mackintosh and towel .
ix. Transfer forceps in a sterile
container.
x. Ear medications.
Present these will prevent
the infection forced into the
middle ear.
viii. To protect the bedding
and the garments.
ix.To handle the sterile
supplies.
x. To instill into the ear after
the irrigation.

80. ARTICLES PURPOSE
xi. Iv stand
xii. Spot light and head
mirrors.
xi. To adjust the height of
the irrigator.
xii. To visualize the ear
cavity.

86. Explain the procedure to the patient to win
his confidence and co-operation.
Unless contra -indicated make the patient
to sit on a chair with a back support.
Leaning against the back of the chair.
If the patient condition does not allow for a
sitting position have the patient lying on his
back with the head turned slightly to the
sight to be irrigated’

87. Place the mackintosh and towel under the head to
protect the bedding and the garments.
Place the kidney tray under the ear to be irrigated.
Ask the patient to adjust the position of the kidney
tray against the neck to receive the return flow.
Arrange to provide enough light for the procedure
Arrange the articles conveniently in the patient’s
unit.
If the patient is a child or un-co-operative restrict
the movements.

88. STEPS RATIONALE
1. Wash hands.
2. Cleanse the pinna of
the ear and the external
auditory canal with the
cotton applicator
dipped in the cleaning
solution.
1. To prevent cross
infection .
2. Any discharge
present in these
areas will not be
flushed into the
middle ear.

89. STEPS RATIONALE
3. If an irrigating can is
used, adjust the height
of the can , not more
than 6 inches above the
level of the ear. Open
the clamp and expel the
air from the tubing
(or)
Draw the solution in
3. If air is introduced into
the ear it will produce
loud sounds and cause
discomfort to the patient.
-Adjust the height of
the can helps to regulate
the flow of fluid.

90. STEPS
RATIONALE
to the syringe and expel
the air by holding it
vertically.
3. Test the temperature of
the solution on the inner
aspect of the wrist.
4.Straighten the ear canal
by pulling the pinna of the
ear
3.The temperature
variation between the
fluid and the body
temperature causes
vertigo.
4. A straight auditory
canal allow fluid to reach
upto the

91. STEPS RATIONALE
upward and down ward
and backward in adults.
5.Place the tip of the
syringe or tip of the nozzle
at the opening of the canal
, but do not block the
canal.
tympanic membrane and
wash the area thoroughly
it allows the visualization
of the entire canal.
5. Allows for return flow
to come back to the
kidney tray.

92. STEPS RATIONALE
6. Allow a small amount of
fluid to run over the pinna of
the ear.
7. Direct the fluid towards
the lateral walls of the
auditory canal. Allow a
steady and continous flow of
fluid into the auditory
canal(exert gentle pressure in
case of syringe).
6. To reassure the patient that
the solution is not very hot.
7. If the fluid is directed
straight onto the tympanic
membrane may cause
perforation due to the undue
force. The force of fluid
should not damage the ear
drum.

93. STEPS RATIONALE
8. Irrigate the eye till the
desired effect is achieved (see
that the kidney tray does not
over flow).

97.  Turn the patient to the affected side , so that the drainage
fromtheearisfacilitated.
 Plug the ear loosely with a gauze piece to collect the
drainage.
 Dry the skin in and around the ear and instill medication
ifordered.
 Remove the mackintosh and towel from under the head
astomakethepatientcomfortable.
 Askthepatientinbedenquireforanysignsofgiddiness

98. Collect all the articles used and take them to the
utility room. Clean them first in the cold water
and then with warm soapy water. Rinse them
thoroughly dry them and send for sterilization.
Wash hands.
Record the treatment ,the type of solutions used ,
the effect of treatment along with the date and
time in nurses record.

100. INTRODUCTION:
Ear drops are instilled into the auditory
canal to produce the following local effects :
To combat infection.
To soften the ear wax.
To produce local anesthesia and to reduce pain in
the ear.
To kill an insect lodged in the auditory canal.

101. DEFINITION: Ear instillation is the process of
introducing otic medication or other liquids into
the ear canal.
PROCEDURE:
Explain the procedure to the patient to win his
confidence and co-operation.
If the patient is a child or an un co-operative adult
restrain his hands.
Place the patient in position (side lying position).
Draw the medication in a dropper (take only
minimum amount).

102. Straighten the auditory canal by pulling the ear
pinna upward and backward in case of adults ,
downwards and backwards in case of children.
Instill the medication drop by drop. Instill the
drops on the side wall of the auditory canal.
Instruct the patient to remain in the same for few
minutes .
Plug the ear with a cotton or gauze piece as
indicated.

103. The auditory canal should be thoroughly clean
before instilling the ear drops.
Drops must be warm when they are instilled into
the ear. Otherwise it may cause vertigo . In order
to warm the ear drops place the container in a
bowel of warm water or rinse the dropper 3 or 4
times in hot water and then take the medications.
Place the patient in a side-lying position or in the
dorsal recumbent position with the head

104. Turned to one side with the affected ear upper
most.
Allow 3 or 4 drops trickle down on one side of the
canal (or) that the air may escape from the
auditory canal and the medication may reach up to
the ear drum.
Ask the patient to remain in the same position for
few minutes following instillation.
Plug the ear with a small cotton ball or a small
gauze piece.
Any complaints made by the patient should not be
ignored.

106. INTRODUCTION:
The sense of smell or olfaction , originates in
the nasal cavity , which also acts as a passage way
for respiration.
ANATOMYAND PHYSIOLOGY:
OLFACTORYNERVES (1st cranial nerve):
These are the sensory nerves of smell. They
originate as specialized olfactory nerve endings
(chemo receptors) in the mucous membrane of
the roof of the nasal cavity above the superior
nasal conches.
On each side of the nasal septum nerve fiber

107. PHYSIOLOGYOFSMELL:
The human sense of smell is less acute than in
other animals.
Many animals secrete odorous chemicals called
pheromones, which play an important part in
chemical communication, for eg-territorial
behavior, making and bonding of mothers and
their newborn.
All odorous materials give off volatile molecules ,
which are carried into the nose with inhaled air and
even very low concentrations, when divided in
mucus , stimulate the olfactory chemoreceptors.

108. The air entering the nose is warmed , and
convection currents carry eddies of inspired air
to the roof of the nasal cavity
Sniffing concentrates volatile molecules in the
roof of the nose.
this increases the number of olfactory receptors
of simulated and thus perception of the smell
increase.
The sense of the smell may effect the appetite. It
the odours are pleasant the appetite may improve
and vice versa.

109. When accompanied by the sight of food an
appetizing smell increases salivation and
stimulates the digestive system

110. When an individual is continuously exposed to
an odour, perception of the odour decreases and
ceases with in a few minutes. This loss of
perception effects the specific odour

112. INTRODUCTION
Occasionally nasal irrigation are ordered to
cleanse the nose, to apply heat to relieve
congestion, swelling and pain
To give relief to the patients with chronic
atrophic rhinitis or prior to the local
application of an oestrogenic compound.
However, nasal irrigation are not commonly
ordered because of the potential danger of
forcing infected matter into the patient’s
Eustachian tubes or sinuses or both

113. Explain the procedure to the patients to win his
confidence and cooperation.
The patient must be asked to breath through the
mouth and to cough, speak, or swallow.
Place the patient in a sitting position on a chair or
in bed with the head bending forward.
Use an irrigation can with a tubing keeping it
12inches above the nose.

114.  maintain a steady and continues stream of
solution into one of the nostrils and allow the
fluid to run out of the other nostril. When the
desired effect is achieved , stop the procedure
dry the nasal passages and make the patient
comfortable.

115. As far as possible nasal irrigations are avoided
because of the potential hazards of forcing
infected materials to the adjacent cavities.
Nasal irrigations are given only on the return
order of a doctor.
The solutions used for the nasal irrigations are
normal saline or any mild anti septic order by
the doctor.
It should not be harmful for the patient if it is
swallowed accidentally

116.  since the patient may feel hard to speak cough or
swallow it is desirable to teach him how to old
the tip of the nozzle, how to remove it and how
to control the flow of fluid. if properly taught, the
patient can take the irrigation by himself.

117. DEFINITION: A nasal instillation a medicine
solution prepared for administration into the nose.
Nasal medicine is given in the form of nose drops (or)
sprays.
PURPOSE:
 To combat infection
 To provide astringent effect
 To relive inflammation and congestion in case of
rhinitis
 To give local anesthesia.

118. Medications are instill only on written
order from the doctor.
Avoided oil base solutions as nasal drops,
since it interfere with the normal ciliary
action and may cause aspiration
pneumonia . If aspirated into the lungs.
Avoid the use of decongestant drops for a
long period or there frequent use or
excessive use, because there become
ineffective and mat actually worsen the
patient nasal congestion

119. Be careful to use to drugs with correct
concentration.
Indentify the drug correctly. Follow the
rules for the administration of medication
“RIGHT PATIENT” etc…

120.  Explain the procedure to the patient.
 Place the patient in the desired position.
 Take the medication in the dropper and instill not
more than 3 drops into each nostril.
 Ask the patient to remain few minutes in the same
position for few minutes provide a hand kerchief
or a piece of rag to wipe off any medication that
have escaped from the anterior nares .
 Provide a sputum mug to spit any medication that
have reached the mouth and throat .

121. At the end of the topic we could know clearly
about the procedures of eye instillation, eye
irrigation, ear instillation and ear irrigation and
nasal instillation and nasal irrigation
We also can know the drugs which are used in a
certain dosage and their action and their
particular usage
This procedures can’t be known or used with out
the doctor’s prescription or advice, so this should
be consulted whit the doctor .