care of ear,eyes, nose for nursing

2. CARE OF THE EYES, NOSE AND EARS:
Hygienic care of the eyes, ears and nose prevents
infection and helps to maintain their functions.
Essential Steps in Eye, Ear and Nose
•Eyes are cleaned from the inner to the outer cantus
•During a bath, each eye is cleaned with a separate
portion of the wash cloth
•Excessive accumulation of secretions make patient sniff
or blow the nose
•The patients who cannot remove secretions needs
assistance to clear the congestion and protect from nasal
mucosa
•Babies and small children a wisp of cotton moistened with
warm water or oil, introduced into the anterior nares and
rotated gently, cleanses the nostrils

3. Purpose
•To maintain the cleanliness of eye,
ear and nose
•To prevent infection
•To keep the organ in normal
functioning
•To prevent obstruction

4. Factor Affecting
•Systemic disease condition (diabetes and
hypertension)
•Acute illness (viral or bacterial infection)
•Trauma (blow or foreign bodies)
•Medication (toxic drugs)
•Allergic substances
•Congenital anomalies

5. Common Problems
Eye: conjunctivitis (burning, itching, red-watery and
painful eyes with increased secretions) cataracts,
glaucoma, strabismus and squint
Ear: otitis media, impacted cerumen and foreign
bodies
Nose: mechanical irritation and obstruction

6. General Instructions
Eye
•Unconscious patients are at risk for eye injury. Daily swabbing of
eye with wet sterile cotton is important
•Cleaning is done from the inner canthus of eye to the outer
canthus of the eye
•Use normal saline to remove the crust
•During bath, each eye is cleaned with a separate portion of the
wash cloth
•When sterile procedure is required, each eye cleaned with
separate swabs, swabbing each once only

7. Ear
•Do not use pins or slides to clean ears. Only use clean buds to
clean ears
•Poor hygiene of ear, debris may accumulate behind the ear and in
the anterior aspect of the external ear
Nose
•Observation of nose for signs of discharge, lesions, edema and
deformity is required
•External crusted secretions can be removed with a wet wash cloth
or a cotton applicator moistened with oil, normal saline or water
•Foreign bodies and small children a wisp of cotton moistened with
water or oil, introduced into the anterior flares, and rotated gently
cleanse the nostrils

8. Preliminary Assessment
Check
•Patients diagnosis
•Doctors order for specific instructions
•Assess the general condition
•Self-care ability
•Articles available in the unit
Preparations of the Patient and Environment
•Explain the procedure
•Arrange the articles at the bedsides
•Place the patient in flat if the condition permits
•Protect the pillow and the bed with a Mackintosh and towel under
the head

9. Eye Care
Eye care is carried out for a number of reasons: to clean the
eye of discharge and crusts; prior to eye drop installation; to
soothe eye irritation; to prevent corneal damage/abrasion in
the unconscious/sedated patient
Equipment Needed
•Clean trolley
•Sterile dressing pack containing a gallipot, gauze swabs and
disposable towel
•Sterile 0.9% sodium chloride
•Sterile gloves
•Appropriate eye ointment/drops (as prescribed)

10. •Good light source
•Disposable bag for rubbish
The patient should be sitting or lying with their head tilted
backwards and chins pointing upwards. This allows for easy
access to the eyes and is a good position for patient comfort.
Procedure: explain to the patient what you are about to do
even if the patient is unconscious. Make sure the bed area is
clear of any obstructions to enable you to move around the
bed freely, and that you have all the equipment-ensuring you
are prepared means you will not have to leave the patient
unnecessarily during the procedure

11. •Make sure that the patient is in a comfortable position and that
there is a good light source
•Ensure patients privacy
•Make an assessment of the patients eyes
•Wash hands, put on gloves and open sterile pack
•Place disposable towel around the patient’s neck
•Ask the patient to close their eyelids, to avoid damage to the cornea
•With a gauze swab dampened in the saline 0.9% gently swab from
the inner aspect (nasal corner) of the eye outwards. Use a new swab
each time until all discharge has been removed
•Repeat the procedure for both eyes
•Dry the patient’s eyelids gently to remove excess fluid

12. •Dispose of equipment
•Ensure that patient is comfortable
•Wash hands thoroughly
•At this point, if required, eye ointment/drops are instilled
•The medicine prescription should be checked against the label on
the eye ointment/drops prior to cleaning patient’s eyes. The expiry
date should also be checked on the medication
•Check the patient’s prescription sheet for the date and time of
administration
•Make sure that you have the correct eye ointment/drop for each
eye

13. •Ensure the patient is in a comfortable position head titled back and
supported
•The patient should be warned if the medication is likely to cause
side effects, such as blurred vision
After Care
•Instill any medications that are ordered
•Remove the Mackintosh and towel from under the patient head
•Adjust the position of the patient
•Replace the articles to the utility room
•Wash hand thoroughly
•Record and report the procedure in the nurse’s record

14. Care of the Ears
•The ears are cleaned during the bed bath. A clean corner of a
moistened washcloth rotated gently into the ear is used for cleaning.
Also, a cotton-tipped applicator is useful for cleansing the pinna
•The care of the hearing aid involves routine cleaning, battery care
and proper insertion techniques. The specialist must assess the
patient’s knowledge and routines for cleaning and caring for his
hearing aid. The specialist will also determine whether the patient
can hear clearly with the use of the aid by talking slowly and clearly
in a normal tone of voice. Have the patient suggest any additional
tips for care of the hearing aid

15. When not in use, the hearing aid should be stored
where it will not become damaged. The hearing aid
should be turned off when not in use. The outside of
the hearing aid should be cleaned with a clean, dry
cloth. Hearing loss is a common health problem with
the elderly, and the aid assists in the ability to
communicate and react appropriately in the
environment

16. care of the Nose
•Secretions can usually be removed from the nose by having
the patient blow into a soft tissue. The specialist must teach
the patient that harsh blowing causes pressure capable of
injuring the eardrum, nasal mucosa, and even sensitive eye
structures

17. If the patient is not able to clean his nose, the specialist will assist
using a saline moistened washcloth or cotton tipped applicator. Do
not insert the applicator beyond the cotton tip Suctioning may be
necessary if the secretions are excessive. When patients receive
oxygen per nasal cannula, or have a nasogastric tube, you should
cleanse the nares every 8 hours. Use a cotton-tipped applicator
moistened with saline. Secretions are likely to collect and dry around
the tube; therefore, you will need to cleanse the tube with soap and
water