NURSING CARE RELATED TO THE SENSORY AND
NEUROLOGICAL SYSTEMS

1-17

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1-17. IRRIGATING THE EAR

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

b. Wash your hands and assemble the necessary equipment.

(1) Ear irrigation syringe.

 

(2) Irrigating solution.

 

(3) Cotton balls and gauze squares.

 

(4) Emesis basin.

 

(5) Large basin.

 

(6) Sterile solution thermometer.

 

(7) Chux pads.

c. Fill the large basin with hot water and place the container of irrigating solution into it.

d. Approach and identify the patient.

e. Explain the procedure to the patient.

f. Clean the external ear with moistened cotton balls or gauze squares.

g. Wash your hands.

h. Test the temperature of the irrigating solution with the sterile solution thermometer. The solution should be between 95ºF-105ºF (body temperature) to avoid causing dizziness.

i. Assist the patient to a sitting position with the head tilted slightly forward and toward the affected side.

j. Place a chux pad over the patient's shoulders to keep clothing dry.

k. Fill the irrigating syringe with solution and expel all air from the syringe.

l. Instruct the patient to hold the emesis basin against his neck, directly under the ear to be irrigated.

m. Straighten the ear canal.

n. Point the tip of the irrigating syringe upward and toward the back of the ear canal.

o. Direct a steady stream of solution into the ear, aiming toward the roof of the ear canal (figure 1-5).

Figure 1-5. Irrigating the ear.

p. Observe the solution as it returns. Note the presence of cerumen or other matter.

q. Observe the patient for signs of pain, nausea, or dizziness. Stop the irrigation immediately if these symptoms occur. Report to the professional nurse at once. These symptoms could be the result of a disturbance in the middle or inner ear, or may indicate a damaged tympanic membrane.

r. Refill the syringe and repeat the procedure until the return flow of solution is clear, or all of the prescribed solution has been used.

s. Assist the patient to a recumbent position, lying on the affected side for several minutes to facilitate complete drainage of the ear canal.

t. Clean the ear and surrounding skin with moistened cotton balls. Blot dry.

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

v. Wash your hands.

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

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