CARING FOR THE EYES, EARS, AND NOSE
a. General. The eyes, ears, and nose require special attention for cleansing
during the patient's bath. The specialist has the responsibility of assisting patients in the
care of eyeglasses, contact lenses, artificial eyes, or hearing aids. Assessments must
be made of the patient's knowledge and methods used to care for the aids, as well as
any problems he might be having with the aids. Patients with limited mobility cannot
grasp small objects. Patients that have reduced vision or are seriously fatigued will also
require assistance from the specialist.
b. Important Points. The eyes, ears, and nose are sensitive and therefore
extra care should be taken to avoid injury to these tissues. Never use bobby pins,
toothpicks, or cotton-tipped applicators to clean the external auditory canal. Such
objects may damage the tympanic membrane (eardrum) or cause wax (cerumen) to
impact within the canal.
Care of the eyes.
(a) Cleansing of the circumorbital (circular area around the eye) area of
the eye is usually performed during the bath, and involves washing with a clean
washcloth moistened with clear water. Do not use soap because of the possibility of
burning and irritation. The eye is cleansed from the inner to outer canthus. A separate
section of the washcloth is used each time. This is to prevent spread of infection. Place
a damp cotton ball on lid margins to loosen secretions. Never apply direct pressure
over the eyeball. Exudate from the eye should be removed carefully, and as often as
necessary to keep the eye clean.
(b) The eyelashes, tearing, and split-second blink reflex usually keeps
the eyes well protected. An unconscious patient may need frequent special eye care.
Secretions may collect along the margins of the lid and inner canthus when the blink
reflex is absent or when the eyes do not completely close. The physician may order
lubricating eye drops. In some cases, the eyes may be medicated and covered to
prevent irritation and corneal drying.
(c) Many patients wear eyeglasses. The specialist will use care when
cleaning glasses, and protect them from breaking. Eyeglasses should be stored in the
case and placed in the drawer of the bedside stand. Glasses are made of hardened
glass or plastic that is impact resistant to prevent shattering, but they can easily be
scratched. Plastic glasses require special cleaning solutions and drying tissues. Warm
water and a soft dry cloth may be used for cleansing glass lens.