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- Optic, Otic, and Nasal administration
- The major difficulty is in gaining children’s cooperation. Older children need only an explanation and direction.
- Although the administration of optic, otic, and nasal medication is not painful, these drugs can cause unpleasant sensations, which can be eliminated with various techniques.
- Optic, Otic, and Nasal administration
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- Eyedrops and ointments
- Techniques
- One technique involves
- Place the child supine or sitting with the head extended and ask the child to look up.
- Use one hand to pull the lower eyelid downward; the hand that holds the dropper rests on the head so that it may move synchronously with the child’s head, thus reducing the possibility of trauma to a struggling child or dropping medication on the face
- When the lower eyelid is pulled down, a small conjunctival sac is formed; apply the solution or ointment to this area rather than directly on the eyeball
- Another effective technique
- To pull the lower eyelid down and out to form a cup effect, into which the medication is dropped.
- Gently close the eyelids to prevent expression of the medication.
- Wipe excess medication from the inner canthus outward to prevent contamination to the contralateral eye.
- May be difficult to obtain cooperation from the child
- To reduce unpleasant sensations when administering medication
- Eye: Apply finger pressure to the lacrimal punctum at the inner aspect of the eyelid for 1 minute to prevent drainage of medication to the nasopharynx and the unpleasant “tasting” of the drug.
- Ear: Allow medications stored in the refrigerator to warm to room temperature before instillation.
- Nose: Position the child with the head hyperextended to prevent strangling sensations caused by medication trickling into the throat rather than up into the nasal passages
- To reduce unpleasant sensations when administering medication
- One technique involves
- If both eye ointment and drops are ordered, give drops first, wait 3 minutes, and then apply the ointment to allow each drug to work.
- When possible, administer eye ointments before bedtime or naptime because the child’s vision will be blurred temporarily.
- Techniques
- Ears in children
- Technique
- Ear drops are instilled when the child is in the prone or supine position and the head turned to the appropriate side.
- For children younger than 3 years of age, the external auditory canal is straightened by gently pulling the pinna downward and straight back.
- The pinna is pulled upward and back in children older than 3 years age.
- Technique
- Nasal
- Technique
- Remove mucus prior to administration
- Position the child with the head hyperextended.
- Use a football hold for infants
- Insert the tip into the naris vertically, then angle it prior to administration
- Play games with younger children
- Technique
- Infection control concerns
- Eyedrops and ointments
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