This document provides instructions for nurses on instilling ear medications. It discusses that ear drops are used to soften earwax, provide anesthesia, treat infections or inflammation, or remove foreign bodies. The ear canal should be straightened before dropping medication to ensure it reaches the deep structures. Ear drops should be at room temperature and not forced into an occluded ear canal to prevent injury. Nurses must check for allergies, follow orders, and document properly after administering ear drops.

1. Instilling an
Ear Medication
Presented By
Mrs.Usha Rani Kandula, MSc(N),
Assistant professor in Adult health nursing, Department of Clinical nursing, Arsi University,
College of health sciences, Asella, Ethiopia, Institutional email: usharani2020@arsiun.edu.et.

2. EAR MEDICATIONS
-Solutions ordered to treat the ear are often referred to as otic
(pertaining to the ear) drops or irrigations.
-Eardrops may be instilled to soften ear wax, to produce anesthesia, to
treat infection or inflammation, or to facilitate removal of a forgien body,
such as an insect.
-External auditory canal irrigations are usually performed for cleaning
purposes and less frequently for applying heat and antiseptic solutions.

3. -The internal ear is very sensitive to changes in temperature.
-Sudden changes can cause nausea and dizziness.
- Eardrops and irrigation fluids should be at room temperature.
-Before instilling a solution into the ear, the nurse should inspect the
ear for signs of drainage, an indication of a perforated tympanic
membrane.

4. -The internal ear is very sensitive to changes in temperature.
-Sudden changes can cause nausea and dizziness.
- Eardrops and irrigation fluids should be at room temperature.
-Before instilling a solution into the ear, the nurse should inspect the
ear for signs of drainage, an indication of a perforated tympanic
membrane.

5. -Eardrops are usually contraindicated when the tympanic membrane is
perforated.
-If the tympanic membrane is damaged, all procedures must be
performed using sterile aseptic technique; otherwise, medical asepsis
is used when instilling medications into the ear.
-Medication should never be forced into the ear canal especially if it is
occluded (as by wax).

6. -Forcing medication into an occluded eardrum can injure the eardrum.
-Certain conditions have contraindications for specific drugs; for
example, hydrocortisone eardrops are contraindicated in clients with a
fungal infection or a viral infection such as herpes.

7. Equipment
 Medication administration record (MAR)
 Cotton-tipped applicator
 Cotton balls
 Medication
 Non sterile gloves
 Tissue

9. Sl.No Action Rationale
1 Check with client and chart for any
known
allergies.
Prevents the occurrence of
hypersensitivity
reactions
2 Check the MAR against the health care
practitioner’s written orders.
Ensures accuracy in identification of the
medication.
3 Wash your hands. Reduces the transfer of microorganisms.
4 Calculate the dose. Ensures the administration of the correct
dose.
5 Use the identification armband to
properly
identify the client.
Ensures correct client.
6 Explain the procedure to the client. Enhances cooperation.

10. Sl.No Action Rationale
7 Place the client in a side-lying position
with the affected ear facing up.
Facilitates the administration of the
medication.
8 Don non sterile gloves. Decreases contact with body fluid.
9 Straighten the ear canal by pulling the
pinna down and back for children or
upward and outward for adults
(Figure 29-35).
Opens the canal and facilitates
introduction of
medication. The external ear structures of
adults and children are different. If the ear
canal is not straightened properly,
medication
may not reach the deep inner ear
structures.
10 Instill the drops into the ear canal by
holding the dropper at least 1/2 inch
above the ear canal.
Prevents injury to the ear canal.

11. Sl.No Action Rationale
12 Place a cotton ball on the outermost
part of the canal.
Prevents the medication from escaping
when
the client changes to a sitting or standing
position.
13 Wash hands. Reduces the transmission of
microorganisms.
14 Document the drug, number of drops,
time
administered, and the ear medicated.
Documenting the actions of the nurse will
reduce the number of medication errors.
15 Evaluate the condition of the skin in the
outer ear between instillations.
Determines possible skin reaction.
Thanking you