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a. Review the patient's clinical record to verify the order.


b. Wash your hands and assemble the necessary equipment.

(1) Prescribed medication.


(2) Normal saline solution.


(3) Two by two inch gauze squares.


(4) Tissues.

c. Approach and identify the patient.


d. Explain the procedure and the purpose of the medication to the patient.


e. Provide for privacy, if appropriate.


f. If the patient is wearing an eye dressing, remove it by gently pulling down and away from the forehead. Discard the dressing and wash your hands.


g. Remove any accumulation of discharge by cleansing around the eye. Use the procedure outlined in paragraph 1-12a.

(1) If secretions are crusted, apply a moistened gauze square over the closed eye and leave in place for several minutes.


(2) Reapply as necessary until secretions are soft enough to be removed without traumatizing the mucosa.

h. Position the patient.

(1) Supine in bed is the position of choice.


(2) Seated in a steady chair is acceptable.

i. Prepare the medication.


(1) Remove the cap of the medication container, being careful to avoid contamination of the cap.


(2) If administering drops with a measured dropper, fill the dropper to the prescribed dose. (Many medications come in plastic containers that deliver a set dose per drop when the container is gently squeezed.)


(3) If administering an ointment, squeeze out a small amount onto to a sterile gauze square in order to remove any crust that may have formed. Discard the gauze.

j. Instill the medication.

(1) Steady the hand holding the medication against the patient's forehead.


(2) Instruct the patient to look up and to the side.


(3) With your free hand, gently pull down the lower lid of the affected eye, exposing the conjunctival sac.


(4) Instill the prescribed amount of drops or a thin ribbon of ointment into the conjunctival sac (figure 1-4). NEVER instill the medication directly onto the eyeball.


Figure 1-4. Instilling eye drops.

k. Instruct the patient to close the eyes gently (without squeezing the lids shut), and roll the eyes. This will distribute the medication.


l. Remove any excess solution or ointment from around the eye by blotting gently with a clean tissue or gauze square.


m. Apply a fresh dressing if required.


n. Provide for the patient's comfort.


o. Remove supplies from the bedside and store or discard as appropriate.


p. Wash your hands.


q. Record the procedure in the patient's clinical record.

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