Nasal drop instillation in pediatrics is the process of administering liquid medication into a child’s nasal cavity, drop by drop, to treat localized nasal conditions or deliver systemic effects. It’s a non-invasive, clean procedure commonly used in both hospital and home settings.
Indications for Nasal Drop Instillation
| Purpose | Examples |
|---|---|
| Relieve nasal congestion | Decongestants for rhinitis or sinusitis |
| Treat infections | Antibiotic or antifungal drops for sinus infections |
| Allergy management | Antihistamine or corticosteroid drops for allergic rhinitis |
| Control nasal bleeding | Vasoconstrictor drops in cases of epistaxis |
| Administer local anesthesia | Pre-procedure numbing for nasal endoscopy or suctioning |
| Diagnostic aid | Instillation of contrast or sampling agents |
Equipment Needed
A clean tray containing:
- Pair of gloves
- Medication bottle with a dropper
- Small pillow or rolled linen
- Torch light
- Face towel
- Paper bag and kidney tray
Preparation
- Identify the child’s profile.
- Check the physician order.
- Check the label on medication against medication card.
- Explain the procedure to the child and parents.
- Ask the child to gently blow the nose to remove secretions.
- Provide supine position for access to posterior pharynx; tilt the head backward for access to ethmoid or sphenoid sinuses; tilt the head back over the edge of bed or
- place a small pillow under the shoulder; and tilt the head back.
Procedure
- Wash hands.
- Draw medicine up into the dropper.
- Tilt recipient’s head slightly toward you and close the other nostril.
- Ask the child (if older) to breath in and out of the mouth.
- Aim dropper upward toward the eye as you instill the prescribed number of drops (usually 2-3) into each nostril.
- Take care not to touch the sides of the nose with the dropper to prevent contamination of the dropper.
- Keep the child in same position for a few minutes after instillation of the drops.
- Use a face towel or rag piece to wipe off any medication that has escaped from anterior nares.
- Document the procedure immediately.
Instillation of Nasal spray
- Wash hands.
- Check the label with medication card. Review for special instruction.
- Shake the bottle gently and remove the cover.
- To prime the pump press downward on the shoulders of the spray bottle. Press down and release several times into the air until a fine spray appears.
- Gently blow the nose and make child to sit down with head tilted slightly forward.
- Close one nostril. Keep bottle upright as you insert nasal applicator into the other nostril.
- Ask the child (older) to breathe in through the nose and while breathing in, press down firmly and quickly once on the applicators.
- Ask the child to breathe out through mouth.
- After spray, lean head backward for a few seconds.
- Repeat the procedure in other nostrils (if ordered).
- Avoid blowing nose for 15 minutes after using spray.
- Wipe applicator with a clean tissue and replace cover.
- Wash hands.
- Document the procedure.
- Note: If the inhaler contains a cortisone medication, the mouth should be rinsed out with water, without swallowing, after inhaling the dose. This will prevent oral thrush.
Special Considerations
- Avoid nasal drops in children with nasal trauma or recent surgery unless prescribed.
- If the child coughs or sneezes, do not re-administer unless the drop missed entirely.
- For infants, wait 30 seconds before suctioning loosened mucus if needed.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
- Marcia London, Ruth Bindler, Principles of Paediatric Nursing: Caring for Children, 8th Edition, 2023, Pearson Publications, ISBN-13: 9780136859840
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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