UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE
TITLE: ADMINISTERING NASAL MEDICATIONS
Effective Date: May, 2002 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education
Reviewed October, 2003 March, 2005 March, 2008 May 2009
PURPOSE: To provide guidelines for the administration of nasal medications at UWMF Clinics.
DEFINITION: Nasal medications may be administered via drops and sprays are usually given to clean the
nasal passageways, medicate the sinuses and to reduce inflammation, but may be used for additional purposes
as well. The patient’s position for the instillation of nose drops varies slightly, depending on the area to be
treated. If the medication is intended for a eustachian tube, the patient assumes an upright position or a supine
position with the head maintained in the midline.
POLICY: Clinical staff will utilize the following guidelines to administer nasal medications to UWMF
patients. The preparation and administration of a medication should be completed by the same person.
SUPPLIES: Provider’s order, Patient’s record, Medication(s), Dropper, Tissue
1. Check the name and dose of medication against the provider’s order. Clarify any inconsistencies.
2. Wash hands then gather equipment.
3. Identify the patient: include date of birth and verify allergies. Provide privacy during the procedure.
4. Know medications actions, special considerations, safe-dose ranges, purpose of administration, and adverse
5. Prepare medication, adhering to the five rights of drug administration.
Right – drug, dose, time, route, patient
Check the expiration date of the medication
NOTE: Most nasal sprays should be shaken prior to use, check label.
6. Provide patient education:
Explain medication(s), reason(s) for the medication(s), and administration to patient
Explain sensations to expect during administration ( stinging, burning, or choking sensation as solution
drips into the throat).
7. Assess the patient for:
Obstruction of breathing through the nose by asking the patient to close one nostril at a time and
Pain and discomfort.
Discharge, redness, or encrustation of the nares.
a. To instill nose drops, have the client sit in an upright position with the head and nose tilted slightly back.
Pt could also be placed in a supine position with head beyond the edge of the table or pillow under
b. Hold the dropper near the entry to the nostril and instruct the client to
inhale as you drop the appropriate dose into the nostril. Wipe any
access medication from around the nostril.
c. Keep the client's head back for two to three minutes to allow the drops
to roll to the back of the nostril.
d. Repeat in the other nostril.
a. To instill nasal spray, have the client sit or stand erect with the head and nose upright or tilted slightly
b. Remove the cap from the nasal spray, shake the bottle, and gently place the tip of the spray bottle well
into the nostril but away from the septum.
c. Instruct the client to exhale, and then inhale vigorously as you squeeze the bottle to deliver the spray.
d. Repeat in the other nostril.
8. Monitor patient for allergic reaction with symptoms such as SOB, difficulty swallowing, hives or itching
and other complaints.
9. Assess the patient’s ability to administer the spray (if needed for home use).
10. Perform discharge teaching regarding new medications
11. Document (Progress Notes in HealthLink utilizing SmartPhrase: .medinclinic)
Manufacture, Lot #, Expiration date (as indicated)
VIS# (if applicable)
Name, dosage, route of medication, and time given
Assessment and laboratory results relevant to purpose of the medication
Effects of the medication on patient
Teaching about the drug or administration technique
How patient tolerated procedure, i.e., desired effect, adverse reactions
REVISED BY: Carol Decker, RN, MSN, Clinical Staff Educator
REVIEWED BY: LaVay Morrison, RN, BSN, Clinical Staff Educator
WRITTEN BY: Ronnie Peterson, R.N., M.S., Manager of Clinical Support
Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams &
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St.
Louis, MO: Mosby Elsevier.
Medical Director Date