ADMINISTERING NASAL MEDICATIONS

NOVIE CARLA G PAGADUAN Academic Instructor

The administration of medications via the nasal passages.

Review of Anatomy

NASAL MEDICATIONS

Nasal Spray

Nasal Inhaler

Nasal Drops

1. The client will be free of nasal congestion 2. The client will be free of nasal discharge and odor. 3. The client will breathe freely through the nasal passages. 4. The client will be free of sinus pain and nasal pain. 5. The clients nasal passages will be moist and pink.

1. Check Doctors order.

READ the order carefully. Clarify with the doctor what was ordered when writing is not legible.

2. Calculate for the dose ordered.

DO NOT PRESUME or ESTIMATE CALCULATIONS. Use the formula to solve the required dosages. (Keep small calculator in your pocket for a quick assistance in solving).

3. WHEN BRAND NAMES are NOT familiar, ask the Pharmacy to clarify what is the generic name of the drug.

4. Some medications needs patient evaluation or assessment before they are given.

e.g. Antihypertensive Insulin Heparin Chemotherapy Meds.

Check BP - Check Blood Sugar - Check PT, PTT - Check temp. & other specified instructions
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Assess the client for the following: Nasal congestion and nasal obstruction. Nasal discharge and nasal mucosa. Pain/ or discomfort level in the sinuses. Adverse systemic conditions.

5. Check the TEN RIGHTS of medication administration before finally giving the drug to each patient.

Check label 3x. Beware of ambiguous medications

Check amount and strength of each medications.

Instructions Once a day (OD) At bed time (HS) Twice Daily (BID) Three times daily (TID) Four times daily (QID) Every 12hrs (q 12H) Every 8hrs (q 8H) Every 6hrs (q 6H) Every 4hrs (q 4H) Three times a day w/ meals AC (ante cebum) PC (post cebum

Standard Times 0800H 2200H or patients actual bed time 0800H 1800H 0800H 1400H 2000H 0800H 1200H 1600H 2000H 0800H 2000H 0600H 1400H 2000H 0600H 1200H 1800H 2400H 0800H 1200H 1600H 2000H 2400H 0400H Given according to meal times on unit 30 minutes BEFORE meal time 30 minutes AFTER meal time

Oral Route
Sublingual

Others
Through tubes

Parenteral
Intramuscular Intradermal (skin testing) Subcutaneous Intravenous Intratacheal

Topical
Powder/creams Eye/Ear/Nasal/Inhalants Rectal/Vaginal medications

Check patients name in the file, identify room and bed number, check bed tag, ask the patients name if conscious and the most reliable way is check the ID BAND.

Keep dignity. Draw curtain not to expose your patient.

Always put yourself at the patients shoes or consider the patient as your next kin relatives. Treat them with respect and TLC.

Inform the doctor then DOCUMENT! In the medication sheet and the nurses notes.

No! No! NO! NOOOO!!!!

READ! READ! READ! Make friends with the drug literature

especially if it is your first time to encounter such medication. Also, ASK! ASK! ASK! No harm in asking the doctor who ordered the medication for the action and side effects.

Document/sign the medication sheets ONLY after administration. DO NOT record in advance and/or DO NOT DELAYED recording, you might forget it! ALWAYS BRING WITH YOU the medication sheets in giving the medications!

WHERE???!
NURSES NOTES! MEDICATION SHEET!

Use appropriate equipment. E.g., if you are giving insulin, make sure to used the insulin syringe not the tuberculin syringe.

PROCEDURE:
1. Wash hands. Wear mask if needed.

PROCEDURE:
2. Explain the purpose of the medication and the desired head position. 3. Explain the sensation of the medications. 4. If a nasal inhaler is used, explain how inhalers work. 5. Have the client blow nose and assume desired position. Squeeze nose drops into dropper. 6. Have the client exhale and close one nostril.

PROCEDURE:
7. Have client inhale while medication is sprayed into the first nostril.

7. If drops are used, insert dropper and instill the prescribed dosage. Note: Lie down (or have the patient lie on his or her back) on a bed with the head tilted back and the neck supported (allow the head to hang over the edge of the bed or place a small pillow under the neck and shoulders). Cradle an infant in your arms with the head tilted back.

PROCEDURE:
8. Have client blot excess drainage; do not blow nose. 9. Repeat the procedure on the other nostril. 10. Help the client resume a comfortable position. If nose drops are used, have client maintain a therapeutic position.

11. Dispose of soiled articles appropriately. Wash hands.

Who did this?!#@*! When are you going to learn?!

PROCEDURE:
12. Evaluate the effect of the medication in 15 to 20 minutes.

13. Wash hands.