Which technique should the nurse use to administer ear drops to a 4 year old child?

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Ear Drops Medication Administration

Ear Drops Medication

Administering ear medication is a fundamental skill that requires the nurse to either irrigate the ear canal or carefully place drops into the ear canal. Be sure to administer the medication as ordered and in the correct ear. While performing the procedure, educate the patient on proper techniques for home care.

10 KEY FACTS

Some individuals produce an excess of earwax. In some cases, a blockage or impaction of cerumen can occur, and the ear may need to be irrigated to clean the canal out.

Ear infections (acute otitis media) occur when fluid becomes trapped in the middle ear. Pressure can build up, causing pain and diminished hearing on the affected side. Antibiotic drops can be used to treat the infection. Educate the patient to administer medication as prescribed and to finish antibiotic therapy.

To straighten out the ear canal in children less than 3 years of age, pull the Pinna/Auricle (outer part of the ear) back and downwards. This method administers a drop more accurately into the ear by permitting gravity to pull it down. “Child” has the letter “D” for Downward.

To straighten the ear canal for adult patients, you need to pull the Pinna/Auricle (outer part of the ear) back and upwards. This method administers a drop more accurately into the ear canal by allowing gravity to pull it down. “Adult” has a “U” for Upward.

To allow gravity to assist the medication into the middle ear, place the patient on the side with the ear facing up.

When administering a drop, hold the dropper about 1 cm (1/2 inch) above the ear canal while holding the Pinna in the proper position. Do not allow the tip of the dropper to make contact with your hands or the patient. The solution is sterile, and the tip needs to be kept clean.

To allow the medication time to travel to the middle ear and not drain out, keep the patient in the side-lying position or keep the ear facing upward for 2-3 minutes.

The inner ear is sensitive to temperature changes. To prevent vertigo, dizziness, or nausea, make sure the solution is kept at room temperature.

To help disperse the medicine in the ear, you can gently massage the tragus unless contraindicated because of pain.

If drainage is present, confirm that the patient’s eardrum is not perforated. If so, this would be a contraindication for administering the ear drops. If irrigating the ear canal, never put a syringe directly into the canal or forcefully put medication in the ear canal, the pressure could perforate the eardrums.

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Has your child's pediatrician has prescribed or recommended ear drops? Following these steps can help ease the process and ensure the drops work properly:

Getting ready

1. Read all the directions that came with the medicine, and make sure you have the correct bottle.

2. Wash both your hands and your child's hands.

3. Rub the medicine bottle between the palms of your hands or place in warm water to warm the drops.

4. Feel a drop to make sure the drops aren't too hot or too cold.

5. Ask your child to lie down or sit with the affected ear facing up.

6. Observe for any discharge (think yellow or green substance), pus (cloudy) or blood in the ear. If there is any, do not give the medicine to your child.

7. If there is drainage (clear liquid) remove it with a clean tissue or cotton topped applicator. Do NOT clean any more than the outer ear.

Giving the drops

1. Place the wrist of the hand you will be using to give the medicine on the cheek or head.
   

2. Place the dropper/nozzle above your child's ear canal.
   

   For children under age 3:

• Gently pull the outer flap of the affected ear DOWNWARD and backward to straighten the ear canal.

• Look for the ear canal to open.
  

For children over age 3:

• Gently pull the outer flap of the affected ear UPWARD and backward to straighten the ear canal.

• Look for the ear canal to open.
  

1. Squeeze the dropper slowly and firmly to release the right amount of medicine on the side of the ear canal.

2. Try to put the drops in so they can run along the side of the ear canal. This can help let air escape as the medicine flows in.

After giving ear drops

1. Ask your child to remain lying down for a couple minutes to help the medicine reach the deepest part of the ear canal and be absorbed.

2. Gently rub the skin in front of the ear or move the ear to help the drops flow to the inside of the ear.

3. Place a cotton ball in your child's affected ear to help prevent the medicine from leaking out. Replace the cotton ball each time the medicine is given. Avoid putting q-tips into the ear.

4. Rinse the dropper tip in water after each use before capping or returning it to the bottle.

5. Replace the cap immediately after use.

6. Wash your hands and note the time the medication was given.

7. Be sure to use the drops as directed for the length of time prescribed.

More information

• Swimmer's Ear in Children

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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