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Instilling Eye and Ear Medications

• Remove gloves and perform hand hygiene before instilling eye medications.
• Warn patients about potential temporary burning sensation from drops.
• Instill eye medications by holding a cotton ball or clean tissue in the non-dominant hand on the patient's cheekbone, just below the lower eyelid, and gently pressing downward with the thumb or forefinger against the bony orbit, exposing the conjunctival sac.
• Never press directly against the patient's eyeball.
• Ask the patient to look at the ceiling and rest the dominant hand on the patient's forehead, holding the filled medication eyedropper approximately 1 to 2 cm above the conjunctival sac.
• Drop the prescribed number of drops into the conjunctival sac.
• If the patient blinks or closes their eye, causing the drops to land on the outer lid margins, repeat the procedure.
• Apply gentle pressure to the patient's nasolacrimal duct with a clean tissue for 30 to 60 seconds over each eye, one at a time.

Drug Forms

• Tablets: powdered drugs compressed into hard, small discs.
• Foam
• Aqueous solution
• Ointment
• Caplet
• Capsule
• Syrup
• Suppository
• Powder

Effects of Drugs

• Therapeutic effect: the desired effect, or primary effect intended, that is the reason the drug is prescribed.
• Side effect: secondary effect or unintended effect, which may be harmful or potentially harmful, and usually predictable.
• Adverse effects: severe side effects.

Types of Medication Orders

• Stat order: indicates that the medication should be given immediately and only once.
• Single order: for medication to be given once at a specified time.
• Standing order: may or may not have a termination date, and may be carried out indefinitely until an order is written to cancel, or it may be carried out for a specified number of days.
• PRN order: or as-needed order.

Essential Parts of a Drug Order

• Client's full name
• Date and time the order is written
• Name of the drug to be administered
• Dose of the drug
• Frequency of administration
• Route of administration
• Right Assessment
• Right Evaluation

Common Abbreviations

• ac: before meals
• aq: water
• bid: twice a day
• c: capsule
• G, gm, GM: gram
• gtt: drop
• hs: at bedtime
• ID: intradermal
• IM: intramuscular
• IV: intravenous
• Kg, Kg, l, or L: kilogram, liter
• mcg: microgram
• mg: milligram
• OD: right eye
• OS: left eye
• OU: both eyes
• pc: after meals
• Po, PO: by mouth
• prn: when needed
• q: every
• qh: every hour
• q2h: every 2 hours
• q6h: every 6 hours
• qid: four times a day
• qod: every other day
• sc: subcutaneous
• stat: at once
• supp: suppository
• tab: tablet
• tid: three times a day

Check Three Times for Safe Medication Administration

• FIRST CHECK: read the medication record and remove the medication(s) from the client's drawer, verify the client's name and room number, compare the label of the medication against the medication record, and check the expiration date of the medication.
• SECOND CHECK: while preparing the medication, look at the medication label and check against the medication record.
• THIRD CHECK: recheck the label on the container against the medication record before returning to its storage place or before giving the medication to the client.

Ten "Rights" of Medication Administration

• Right Medication
• Right Dose
• Right Time
• Right Route
• Right Client
• Right Client Education
• Right Documentation
• Right To Refuse

Assessing Patient Readiness

• Determine whether the patient has any symptoms of eye or ear discomfort or visual or hearing impairment.
• Assess patient's medical history, history of allergies (including latex), and medication history.
• Assess patient's level of consciousness (LOC) and ability to follow directions.
• Prepare medications for instillation, and check label of medication against MAR 2 times.
• Perform hand hygiene and arrange supplies at bedside.
• Identify patient using two identifiers (i.e., name and birthday or name and account number) according to agency policy.

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