EYE IRRIGATION
1. define eye irrigation.
2. review the anatomy and physiology of the
eye.
3. discuss eye irrigation as to its:
1. purpose
2. indications
3. contraindications
4. complications
5. principles involved
6. guidelines
4. explain the nursing responsibilities
before, during and after the procedure.
5. demonstrate beginning skills in eye irrigation.
Is a medical procedure of washing out of the conjunctival sac with a stream of liquid.
This is use to clean out foreign objects that gets into the eye causing irritation.
ANATOMY & PHYSIOLOGY OF THE
EYE:
Optic tract
Thalamic Nucleus
Optic Radiation
Visual Cortex/ Occipital Lobe
I
R
I
S
PURPOSE OF EYE
IRRIGATION:
To clear the eye of noxious or other foreign
material or excessive secretions or in preparation
for surgery.
To prevent corneal burning.
To flush out irrigating or chemical solutions to the
eye.
To relieve itching.
To treat infections.
INDICATIONS OF EYE
IRRIGATION:
Chemical contact, irrigating after contact
Eye irritants
Excessive secretion
Preparations for surgery
Unconscious patients
Eye inflammation or crusting
CONTRAINDICATIONS OF EYE
IRRIGATION:
Eye surgery
Allergy to medication
COMPLICATIONS OF EYE
IRRIGATION:
Incomplete foreign body removal or Rust
ring
Conjunctivitis
Perforation of the cornea
Epithelial injury
Rust ring
Conjunctivitis
Perforation of the cornea
PRINCIPLES INVOLVED IN EYE
IRRIGATION:
1. Anatomy and Physiology
2. Microbiology
3. Pharmacology
4. Chemistry
5. Physics
6. Psychology
GUIDELINES FOR EYE
IRRIGATION:
1. Position patient in a SUPINE POSITION with head turned slightly toward the affected side.
2. Direct the irrigating solution along the conjunctiva from INNER to OUTER CANTHUS.
3. AVOID touching the eye structure with the irrigation equipment.
4. Place the kidney basin at the SIDE OF THE EYE.
NURSING
RESPONSIBILITIES:
BEFORE
1. Confirm the PATIENT’S IDENTITY by
checking the name band or asking for the
patient’s name and birth date.
2. Gather the NECESSARY MATERIALS.
3. Do MEDICAL HAND WASHING and wear
gloves (as necessary).
4. Position patient in a SUPINE POSITION with
HEAD SLIGHTLY TURNED TO THE
AFFECTED SIDE.
DURING
1. EXPOSE the conjunctival sac and HOLD
UPPER LID OPEN with non-dominant hand.
2. Instruct patient to LOOK UP.
3. Allow solution to flow from the INNER
CANTHUS to OUTER along the conjunctival
sac.
AFTER
1. PAT DRY patient’s face and eyes with a
cotton ball.
2. Document the following:
Duration of irrigation
Type and amount of solution
Characteristics of drainage
Patient’s reactions to the procedure
EYE INSTILLATION
1. define eye instillation.
2. discuss eye instillation as to its:1. purpose
2. indications
3. contraindications
4. complications
5. guidelines
3. explain the nursing responsibilities before, during and after the procedure.
4. enumerate common ophthalmic medications with its classification, mechanism of action, and side effects.
5. demonstrate beginning skills in eye instillation.
Administration of therapeutic agents such as ointments and creams into the eye.
PURPOSE OF EYE
INSTILLATION:
To dilate or constrict the pupil when
examing the eye.
To relieve pain, discomfort, itching and
conjunctivitis.
To act as an antiseptic in cleansing the
eye.
To combat infection.
To lubricate the eye.
INDICATIONS OF EYE
INSTILLATION:
Glaucoma
Papillary dilation for surgery and
examination
Opthalmic infections
Patients requiring local anesthesia for
tests
Eye discomforts
CONTRAINDICATIONS OF EYE
INSTILLATION:
Hypersensitivity to drug use in
instillation.
COMPLICATIONS OF EYE
INSTILLATION:
Allergic reaction
GUIDELINES FOR EYE
INSTILLATION:
Wash hands before putting on gloves
Offer the patient paper tissues to
remove solution and tears that may spill
from eye during the procedure
Clean the eyelids and eyelashes of any
drainage with cotton ball or gauze
Tilt the patient’s head slightly if sitting or
place the patient’s head over a pillow if
lying down
Place the thumb or two fingers near the
margin of the lower eyelid immediately
below the eyelashes, exertpressure
downward over the bony prominence of the
cheek
Hold the dropper close to the eye, but avoid
touching the eyelids or lashes
Squeeze the container and allow the
prescribed number of drops to fall in the
lower conjunctival sac
Release the lower lid after the eyedrops
are instilled, ask patient to close his eyes
gently
Apply gentle pressure over the inner
canthus
Do not apply medications to the cornea
since it can cause injury since it richly
supplies with sensitive nerve endings
Moving the eyes after instillation distributes
the solution over the conjunctival surface
and anterior eyeball
NURSING
RESPONSIBILITIES:
Before
1. Check doctor’s order for amount, no. of drops of solution and eye to be treated.
2. Explain procedure to the patient.
3. Prepare drug to be administered according to the 5R’s of administration.
4. Warm hands.
5. Do gloving.
6. Let patient sit with head tilted backward or to lie in supine position.
During
1. Pull lower lid down gently.
2. Instruct patient to look up.
3. Drop medication amount into center of lower lid and never in the cornea.
4. If using an ointment, apply from inner to outer canthus.
5. Instruct patient to close eyes and not to squeeze or rub the eyes.
After
1. Wipe off excess solution with sterile gauze or
cotton balls.
2. While closing his eyes, let patient roll his
eyes.
3. Record time, type, strength and amount of
medication and the eye into which medication
was instilled
COMMON OPTHALMIC
MEDICATIONS:DRUG CLASSIFICATION/
MECHANISM OF ACTION
SIDE EFFECTS RESPONSIBILITIE
S
Tetrahydrozolin
e hydrochloride
(Geneye)
Opthalmic decongestant
Opthalmic vasoconstrictor
and mydriatric
Dilates pupils; Increases
flow of aqueous humor,
vasoconstricts in eyes.
CNS: fear, anxiety,
tenseness,
restlessness,
headache,
lightheadedness,
dizziness,
drowsiness.
CV: Palpitations,
Tachycardia
GI: Nausea,
vomiting, anorexia
GU: Dysuria
Local: burning,
sneezing, dryness
Other: Pallor,
sweating
Do not administer
ophthalmic solution
if it is cloudy or
changes in color.
Do not exceed
recommended dose.
Demonstrate
proper
administration
technique for eye
drops.
Avoid prolong use
because of
underlying medical
problems can be
disguised.
DRUG CLASSIFICATION/ MECHANISM OF ACTION
SIDE EFFECTS RESPONSIBILITIE
S
Lotemax
(loteprednol
etabonate)
Dexamethason
e
Dexamethason
e phosphate
Fluorometholo
ne acetate
Hydrocortisone
Hydrocortisone
acetate
Loteprednol
etabonate
DRUG CLASSIFICATION/ MECHANISM OF ACTION
SIDE EFFECTS RESPONSIBILITIE
S
Bacitracin (AK-
Tracin)
Ciproflaxin
(Cipro)
Erythromycin
(Ilotycin)
Gentamicin
(Garamycin)
Norfloxacin
(Noroxin)
Oxytetracycline
Polymycin B
Sulfisoxazole
diethanolamine
DRUG CLASSIFICATION/ MECHANISM OF ACTION
SIDE EFFECTS RESPONSIBILITIE
S
Ganciclovir
(Vitrasert)
Idoxuridine
(Herplex)
EAR IRRIGATION
1. define ear irrigation.
2. review the anatomy and physiology of the ear.
3. discuss ear irrigation as to its:1. purpose
2. indications
3. contraindications
4. complications
5. principles involved
6. guidelines
4. explain the nursing responsibilities before, during and after the procedure.
5. demonstrate beginning skills in ear irrigation.
Washing by a stream of water or other fluid, if a wax plug is present in the auditory canal, irrigation is ordinarily done for cleansingpurposes.
ANATOMY AND PHYSIOLOGY OF
THE EAR
PURPOSE OF EAR
IRRIGATION
To clean the auditory canal.
To remove discharges from the ear canal.
To facilitate removal of foreign bodies such as
organic substances.
To soften wax.
To destroy organisms or insects lodging the
canal can cause almost intolerable discomfort.
For hygiene purposes.
INDICATIONS OF EAR
IRRIGATION:
For patients with cerumen impaction
For patients with ear infections
Patients with ear obstructions
Patients with hearing difficulties
CONTRAINDICATIONS OF EAR
IRRIGATION:
Patients with Tympanic membrane
perforation
Patients with Tympanostomy with
tubes
Tympanic membrane perforation
COMPLICATIONS OF EAR
IRRIGATION:
Dizziness
Perforation or damage of the Eardrum
PRINCIPLES INVOLVED:
1. Anatomy and Physiology
2. Physics
3. Microbiology
4. Psychology
5. Chemistry
GUIDELINES FOR EAR
IRRIGATION:
1. Warm the solution 35-40 degree
Celsius.
2. Wear gloves.
3. Straighten the auditory canal
-be sure not to occlude the meatus.
NURSING
RESPONSIBILITIES:
Before
1. Read/check physicians order
2. Explain procedure
3. Do medical hand washing
4. Assist patient in sitting position/Head
tilt.
During
1. Place a towel under the
shoulder
2. Support a basin under the
patient ear.
After
1. Document:
- Time of irrigation
- Effect of treatment.
- Kind and amount of solution used.
- Nature of the returned flow.
2. Do after care.