Control No.

_____
Republic of the Philippines
UNIVERSITY OF EASTERN PHILIPPINES
University Town, Northern Samar
Website: uep.edu.ph Email: ueppres06@gmail.com

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

ADMINISTERING NASAL MEDICATION

DEFINITION
 Administration of medication via nasal route.

PURPOSE
 To relieve nasal congestion.
 To treat infection.

EQUIPMENT
 Nasal drop solution.
 Disposable gloves (optional)
 Tissue paper
 Pillow roll (or large towel into pillow roll)

PROCEDURE
1. Check the doctor’s order
2. Observe the 5R’s drug administration.
 Right patient
 Right drug
 Right dose
 Right time
 Right frequency
3. Assess the client`s nasal congestion and nasal
obstruction, presence of nasal discharges and
discomfort level in the sinuses.
4. Wash hands.
5. Assemble the equipment.
6. Identify and explain to client regarding positioning and
sensation to expect such as burning or tingling
sensation.
7. Wear Gloves.
8. Instruct client to blow nose gently unless
contraindicated, if excess mucus noted.
9. Position client in sitting position with head tilted slightly
backwards or in supine position with head tilted back in
a slightly extended position with a small pillow rolled
under client`s neck.
10. Squeeze top medication dropper with dominant hand.
11. Hold the dropper 1 cm (1/2 inch) above nares and
instill the prescribed number of drops.
12. Instruct the client to take one short deep breath and to
remain in position for 3 to 5 minutes.
13. Discard gloves and restore equipment properly.
14. Wash hands.
15. Record the procedure.
RATIONALE
 To ensure correct administration of
medication.
 Prevents error in drug administration.
 To determine any sign of infection and
establish a baseline for future
assessment.
 To reduce transfer of microorganisms.
 To promote efficiency.
 Helps client to anticipate experience of
procedure to reduce anxiety.
 Avoids exposure to nasal secretions.
 Remove mucus and secretions that can
block distribution of medication.
 Facilitates proper channeling of drug
through nasal passage for optimal
absorption.
 Suctions solution into dropper.
 To avoid inserting bacteria in the
medication bottle.
Facilitates full absorption of drug.
 Promotes cleanliness.
 To reduce transfer of microorganisms.
 To provide accurate data needed in the
 care of client.
Control No._____
Republic of the Philippines
UNIVERSITY OF EASTERN PHILIPPINES
University Town, Northern Samar
Website: uep.edu.ph Email: ueppres06@gmail.com

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

PERFORMANCE EVALUATION CHECKLIST

ADMINISTERING NASAL MEDICATION

Procedure Able to Able to Unable

Perform Perform with to
Assistance Perform
Assessment
1. Assess the client`s nasal congestion and nasal obstruction.
2. Assess client`s nasal discharges, its volume and odor.
3. Assess the client`s pain or discomfort level.
Planning
4. Wash hands.
5. Assemble the equipment.
Implementation
6. Check the doctor`s order.
7. Observe the 5R`s in drug administration.
8. Identify and explain the procedure.
9. Wear gloves.
10. Position client in sitting with head tilted slightly backwards, or
supine with head tilted in slightly extended.
11. Hold the dropper 1 cm (1/2 inch) above the nares and instill
the prescribed number of drops
12. Instruct client to remain in position for 3 to 5 minutes.
13. Discard gloves and soiled equipment.
14. Wash hands.
Evaluation
15. Evaluate client`s response to medication.
Documentation
16. Record the drug, dosage and time administration.
17. Document client`s response to the medication.
18. Record any untoward reaction after the medication
administration.
Remarks:

Grade

Rating Scale:

Excellent : 96-100%
Very Satisfactory : 90-95%
Very Good : 85-89%
Good : 80-84%
Fair : 75-79%
Poor : 74 & below
 Clinical Instructor Student`s Signature

Control No._____
Republic of the Philippines
UNIVERSITY OF EASTERN PHILIPPINES
University Town, Northern Samar
Website: uep.edu.ph Email: ueppres06@gmail.com

COLLEGE OF NURSING AND ALLIED HEALTH SCIENCES

PERFORMANCE EVALUATION CHECKLIST

ADMINISTERING NASAL MEDICATION

PROCEDURE Able to Able to Unable
Perform Perform to
(2) with Perform
Assistance (0)
(1)
1. Check the doctor’s order
2. Observe the 5R’s drug administration.
 Right patient
 Right drug
 Right dose
 Right time
 Right frequency
3. Assess the client`s nasal congestion and nasal
obstruction, presence of nasal discharges and
discomfort level in the sinuses.
4. Wash hands.
5. Assemble the equipment.
6. Identify and explain to client regarding positioning and
sensation to expect such as burning or tingling
sensation.
7.Wear Gloves.
8. Instruct client to blow nose gently unless
contraindicated, if excess mucus noted.
9. Position client in sitting position with head tilted slightly
backwards or in supine position with head tilted back in
a slightly extended position with a small pillow rolled
under client`s neck.
10. Squeeze top medication dropper with dominant hand.
11. Hold the dropper 1 cm (1/2 inch) above nares and instill
the prescribed number of drops.
12. Instruct the client to take one short deep breath and to
remain in position for 3 to 5 minutes.
13. Discard gloves and restore equipment properly.
14. Wash hands.
15. Record the procedure.

Remarks:___________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Grade: _____________

______________________________ __________________________
Clinical Instructor Student’s Signature