GRADED
TRIAL
# 1
GRADED
TRIAL
# 2
NOTES
1. ✶ Identify the patient and explain
the procedure.
2. ✦ Review the physician’s order.
3. ✦ Assemble the equipment. Check
the label of the irrigating solution
three times to ensure it is the
correct solution and concentration
ordered by the physician. Check
the expiration date on the label
to make sure the solution has
not expired. The solution should
be brought to room temperature
by wrapping the bottle in a dry
heating pad or standing the bottle
in a warm water bath.
4. ✦ Perform hand hygiene and apply
gloves.
5. ✦ Ask which position the patient
would prefer, sitting or lying
down.
6. ✦ Place a towel over the patient’s
shoulder. If both eyes are to be
irrigated, then two separate sets
of equipment must be used to
prevent cross-infection.
7. ✦ Pour irrigating solution into the
sterile basin, and withdraw the
solution directly from the basin,
using the syringe.
8. ✦ Ask the patient to tilt the head to
the aected side, if seated, and
hold the kidney-shaped emesis
basin against the cheek below the
eye to catch run-o fluid.
9. ✶ Open the patient’s eye using the
index finger and thumb of the
nondominant hand.
POINT VALUE
✦ = 3–6 points
✶ = 7–9 points
Name: ________________________________________
Date: _________________________________________
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