• DEFINATION

Washing of the eye externally using stream of

water or other medicated fluids .
• PURPOSES
1. To clean the eye.
2. To remove foreign particles, excessive
secretion or discharge.
3. To apply heat or cold.
4. To reduce inflammation .
5. To relieve discomfort.
• ARTICLES NEEDED
1. Eye irrigator (undine) / syringe without
needle.
2. Large cotton swabs .
3. Mackintosh .
4. K-basin-2
5. Irrigating solution (sterile)

PROCEDURE
Nursing action
PROCEDURE
1.Identify the patient and
provide explanation as to
what will be done and how
he may cooperate.
2. Assemble articles at the
bedside .
3. Wash and dry hands .
Rationale
•Provide for performance of
procedure on correct
patient.
• decreases patient’s anxiety
and promotes cooperation.
Facilitates orderly
performance of procedure.
4.Expose the lower
conjunctival sac by
separating the lids with
the thumb and forefinger .
Exert pressure on the
bony prominence of the
cheek bone and on the
eye brow when holding
the eyelids .

5. Hold the filled eye Ensures an even ,safe

irrigator about 2.5 cm pressure of the solution
(1inch) above the eye. and avoids possible injury
to cornea.
6. Irrigate the eye Directing the solution in
directing the solution on this way prevents fluid
the lower conjunctival sac, from flowing down the
from inner canthus to the nasolacrimal duct .
outer canthus .
7. Irrigate until the
solution leaving the eye is
clear (or) until all the
solution has been used .
8. Dry around the eye Prevents infection.
with cotton swabs.
9. Apply ointment if Aids in healing and
prescribed by physician. prevents infection.
10. Discard the irrigated Prevents transmission of
fluid and swabs and micro-organisms.
sterilize and replace all
the reusable articles .
Wash hands.

11. Record the treatment Serves as a legal

showing amount and color documents.
of discharge , consistency
of discharge,
Cont,....
Presence of redness and Prevents complication.
swelling ,and treatment
given.

12. Refer the patient to

the physician if the eyes
show evidence of
ulceration.
EAR IRRIGATION
PERFORMING EAR IRRAGATION
DEFINiTION
An ear irrigation is the washing of the external
auditory canal with a stream of liquid.
PURPOSES
1. To remove the earwax.
2. To remove foreign bodies (except hygroscopic
substances).
3. To cleanse the ear in case of purulent
discharge caused by middle ear infection.
4. For antiseptic effect.
5. To apply heat.
6. To evaluate vestibular functions (e.g. Bithermal
calorie test).

SOLUTIONS USED
1. Boric acid 2-4%
2. Sodium bicarbonate solution 1%
3. Normal saline.
4. Hydrogen peroxide 2%
5. Sterile water
ARTICLES
1. Prescribed sterile irrigating solution (warmed to 37
degree centigrade).
2. Irrigation set ( container and irrigating bulb syringe ).
3. Waterproof pad.
4. Emesis basin.
5. Cotton tipped applicators.
6. Clean gloves.
7. Cotton balls.
8. Spot light and head mirror.
9. Sterile gauze piece.
10.Sterile jug with extra fluid.
 PROCEDURE

Nursing action Rationale

1. Explain the procedure Explanation facilitates
to the patient and cooperation and provides
inform him how he has reassurance .
to cooperate.

2. Bring equipment to the Provides for an organised

patient’s bedside. Click approach to the task.
the physician’s order,
protect the patient and
bed linen with a
moisture proof pad.
3. Wash hands Prevents spread of micro-
organisms.
4. Have the patient sit up Gravity causes the
or lie with the head tilted irrigating solution to flow
toward the side of the from the ear to the basin.
affected ear. Have the
patient support the basin
under the ear to receive
the irrigating solution.

5. Clean the pinna and Materials lodged on the

meatus at the auditory pinna and at the meatus
canal as necessary with may be washed into the
moistened cotton-tipped ear.
applicators dipped in
Contd....
6. Ascertain whether
impaction is due to
foreign hygroscopic
(attracts or absorbs
moisture ) body before
proceeding.
7. Fill the bulb syringe
with warm solution , if an
irrigating container is used
, allow air to escape from
the tubing .
If water contracts such a
substance it may cause it
to swell and produce
intense pain.
Air forced into the ear
canal is noisy and
therefore unpleasant for
the patient.
Contd....
8. Straighten the auditory Straightening the ear
canal by pulling the pinna canal helps to allow the
up and back for an adult , solution to reach all areas
upward and back for a of the ear canal.
child over 3 years of age
and down and back for an
infant or child up to 3
years of age.

9. Direct a steady, slow Directing solution at the

stream of solution against roof of the canal helps
the roof of the auditory prevent injury to the
canal , using only tympanic membrane.
sufficient force to remove Continuous in and out of
Contd.....
Secretions . Do not Of the irrigating solution
occlude the auditory canal helps to prevent pressure
with the irrigating nozzle. in the canal.
Allow the solution to flow
out unimpeded.

10. When the irrigation is The cotton ball absorbs

completed, place a cotton
ball loosely in the auditory
meatus and have the
patient lie on the side of
the affected ear on a
towel or absorbent pad.
excess fluid and gravity
allows the remaining
solution in the canal to
escape from the ear.
contd....
11. Discard the irrigated
fluid and swabs . Clean and
replace reusable articles.

12. Wash hands. Prevents spread of micro-

organisms.
13. Record the irrigation, Acts as a communication
appearance of the drainage between staff members.
and the patient’s response .
14. Remove the cotton ball Drainage or pain may
and assess drainage after indicate injury to the
15 minutes. tympanic membrane.
SPECIAL CONSIDERATIONS
1. Irrigation solution should be at least at room
temperature .
2. An irrigating container with tubing and an ear
tip may be used if the purpose of the
irrigation is to apply heat to the area.
3. If irrigation does not dislodge the wax, instill
several drops of prescribed glycerin,
carbonide peroxide or other solutions as
directed , two or three times daily for 2-3
days which helps to soften and loosen
impaction .
4. Take special care to irrigate an older adult’s
ears with cool water because dizziness may
occur.