A 2-year-old child is ordered to have eardrops daily. which action will the nurse take?

Drug information provided by: IBM Micromedex

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Missed Dose
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What action is correct when administering ear drops to a 2 year old child?
What actions can a nurse use to reduce the risk of a needlestick injury in practice select all that apply?
What is the nurse's priority action to protect a client from medication error?
What is the most important role of the nurse in preventing drug errors?

Ofloxacin eardrops comes with patient information and instructions (Medication Guide). Be sure to read these instructions before using the eardrops . If you have any questions, check with your doctor or health care professional.

To use:

Hold the bottle in your hands for 1 or 2 minutes to warm up the solution before putting it in your ear. Otherwise, putting cold solution in your ear could cause you to become dizzy.
Wash your hands with soap and water.
Gently clean any discharge that can be removed easily from the outer ear, but do not insert any object or swab into the ear canal.
If you are using the eardrops for a middle ear infection—Drop the medicine into the ear canal. Then, gently press the tragus of the ear (see the diagram in the Medication Guide) four times in a pumping motion. This will allow the drops to pass through the hole or tube in the eardrum and into the middle ear.
If you are using the eardrops for an ear canal infection—Gently pull the outer ear up and back for adults (down and back for children) to straighten the ear canal. This will allow the eardrops to flow down into the ear canal.
Keep the ear facing up for about 5 minutes to allow the medicine to come into contact with the infection.
If both ears are being treated, turn over after 5 minutes, and repeat the application for the other ear.
To keep the medicine as germ-free as possible, do not touch the applicator tip to any surface (including the ear). Also, keep the container tightly closed.

To help clear up your infection completely, keep using this medicine for the full time of treatment, even if your symptoms have disappeared. Do not miss any doses.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For eardrops dosage form:
- For ear infections:
  - Adults and teenagers (12 years of age and older)—Place 10 drops in each affected ear two times a day for ten to fourteen days, depending on the infection.
  - Children 1 to 12 years of age—Place 5 drops in each affected ear two times a day for ten days.
  - Children younger than 1 year of age—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

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Portions of this document last updated: Aug. 01, 2022

Chapter 31: Medication Administration

Potter et al.: Fundamentals of Nursing, 10th Edition

MULTIPLE CHOICE

1. A nurse is teaching a patient about medications. Which statement from the patient indicates teaching is effective?

a.“My parenteral medication must be taken with food.”

b.“I will rotate the sites in my left leg when I give my insulin.”

c.“Once I start feeling better, I will stop taking my antibiotic.”

d.“If I am 30 minutes late taking my medication, I should skip that dose.”

ANS: B

For daily insulin, rotate site within anatomical area. Rotating injections within the same body part (instrasite rotation) provides

greater consistency in absorption of medication. Parenteral medication absorption is not affected by the timing of meals. Taking a

medication 30 minutes late is within the 60-minute window of the time medications should be taken. Medications are usually

stopped based on the provider’s orders except in extenuating circumstances. With some medications, such as antibiotics, it is

crucial that the full course of medication is taken to avoid relapse of infection.

DIF: Apply (application)

OBJ: Discuss nursing roles and responsibilities in medication administration.

TOP: Teaching/Learning MSC: Pharmacological and Parenteral Therapies

A nurse is preparing to administer an injection to a patient. Which statement made by the patient is an indication for the nurse to

use the Z-track method?

a. “I am allergic to many medications.”

b.“I’m really afraid that a big needle will hurt.”

c.“The last shot really irritated my skin around the site.”

d.“My legs are too obese for the needle to go through.”

ANS: C

The Z-track is indicated when the medication being administered has the potential to irritate sensitive tissues. It is recommended

that, when administering IM injections, the Z-track method be used to minimize local skin irritation by sealing the medication in

muscle tissue. The Z-track method is not meant to reduce discomfort from the procedure. If a patient is allergic to a medication, it

should not be administered. If a patient has additional subcutaneous tissue to go through, a needle of a different size may be

selected.

DIF: Apply (application)

OBJ: Describe factors to consider when choosing routes of medication administration.

TOP: Planning MSC: Pharmacological and Parenteral Therapies

A 2-year-old child is ordered to have eardrops daily. Which action will the nurse take?

a.Pull the auricle down and back to straighten the ear canal.

b. Pull the auricle upward and outward to straighten the ear canal.

c.Sit the child up for 2 to 3 minutes after instilling drops in ear canal.

d.Sit the child up to insert the cotton ball into the innermost ear canal.

ANS: A

Children up to 3 years of age should have the auricle pulled down and back, children 3 years of age to adults should have the

auricle pulled upward and outward. Solution should be instilled 1 cm (1/2 in) above the opening of the ear canal. The patient should

remain in the side-lying position 2 to 3 minutes. If a cotton ball is needed, place it into the outermost part of the ear canal.

DIF: Apply (application)

OBJ: Correctly and safely prepare and administer medications. TOP: Implementation

MSC: Pharmacological and Parenteral Therapies

4. A patient has been prescribed to receive 0.3 mL of U-500 insulin. Which syringe will the nurse use to administer the medication?

a.3-mL syringe

b.U-100 syringe

c.Needleless syringe

d.Tuberculin syringe

ANS: D

Because there is no syringe currently designed to prepare U-500 insulin, many medication errors result with this kind of insulin. To

prevent errors, ensure that the order for U-500 specifies units and volume (e.g., 150 units, 0.3 mL of U-500 insulin), and use

tuberculin syringes to draw up the doses. A 3 mL and U-100 can result in inaccurate dosing. A needleless syringe will not be

acceptable in this situation.

DIF: Understand (comprehension)

OBJ: Implement nursing actions to prevent medication errors. TOP: Planning

MSC: Pharmacological and Parenteral Therapies

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What action is correct when administering ear drops to a 2 year old child?

For children under 3: Hold ear lobe and gently pull down and back. For children 3 and over: Hold upper part of ear and gently pull up and back. 2. Place the correct number of drops into the ear canal so they will roll into the ear along the side of the ear canal.

What actions can a nurse use to reduce the risk of a needlestick injury in practice select all that apply?

Eliminate the use of needle devices whenever safe and effective alternatives are available. Provide needle devices with safety features. Provide sharps containers for workers to bring into clients' homes. Investigate all sharps-related injuries.

What is the nurse's priority action to protect a client from medication error?

The first, and most critical step a nurse should take if a medication error is made is to assess the patient for adverse reactions.

What is the most important role of the nurse in preventing drug errors?

However, the role of nursing administrators in reducing and preventing these errors is vital. Although most medication errors can be minor and may not harm the patients, they need more supervision and planning. Reporting medication errors is an ethical duty to maximize the benefits of patient care.