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Clinical Skills · Miscellaneous Medication Administration

Administering Nasal Medications

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7 key termsSourcesReport an error
Technique details (priming, head position, aiming, sniffing) are commonly taught practices and vary by device and manufacturer; always follow the product's instructions, the institution's procedure manual, and prescriber orders, and note that scope of practice varies by state and setting.
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On this page 9 sections
  1. In 30 seconds
  2. Why this matters
  3. The college version
  4. Eli explains
  5. Worked example
  6. Key takeaway
  7. Check yourself
  8. Study tools
  9. Sources & references

In 30 seconds

Nasal medications are delivered through the nostrils onto the — the moist, blood-rich lining of the nose — most often as sprays, drops, or gels. The route is used for local effects (decongestants, saline, corticosteroids, and allergy medications that act on the nasal lining) and, less commonly, for systemic effects, because the nasal mucosa's rich blood supply allows some drugs to be absorbed directly into the circulation. The technique is the whole story on this route: the goal is to coat the mucosal surface — especially the , the shell-like ridges on the side walls of the nose — rather than to blast the medication against the septum (the wall between the nostrils) or simply sniff it down the throat. Device design varies (metered-dose pumps, squeeze bottles, droppers), so the nurse always checks the product's instructions — and teaching correct self-administration is often the difference between a medication that works and one that drips out or irritates.

Why this matters

The nasal lining is delicate and highly vascular, which cuts both ways. Aimed at the wrong spot, a spray can irritate or damage the septum and cause nosebleeds; inhaled too hard, a dose can land in the throat instead of the nasal passages. Overuse of decongestant sprays can lead to — the nose becomes more congested as the medication wears off, which is why patient teaching about duration of use matters. Because the mucosa absorbs into the bloodstream, nasal medications can have body-wide effects, and shared devices can spread infection from one person to another. Nurses also give nasal medications for systemic purposes (some hormones, migraine medications, and emergency reversal agents come in intranasal forms), so "it's just a nose spray" is a real safety trap.

The college version

Core Concepts

Anatomy: where the medication should land

Air enters through the (nostril openings), passes the (the midline wall) and the turbinates (curved ridges on the outer walls that warm and humidify air), and continues into the nasopharynx. For medication purposes, the key idea is surface area and airflow: the turbinates provide most of the nasal mucosa's surface, so sprays should be directed toward the outer wall of the nasal passage, slightly away from the septum. A spray aimed straight at the septum concentrates the medication (and its preservatives) on one delicate spot, which can cause irritation and bleeding. The nose also drains backward into the throat — which is why a hard sniff after spraying pulls the dose down the throat instead of letting it coat the mucosa.

Devices and preparation

Common forms include metered-dose nasal sprays (a pump that delivers one measured spray per activation), squeeze-bottle sprays (used for saline rinses), drops (instilled with the head tilted back), and gels (applied per product instructions). Before use, prime new or unused pumps per the manufacturer's instructions (often a few test sprays into the air) so the first dose is not half-empty. Check the order for the medication, dose, and whether one or both nostrils are specified, and confirm the discard date on multi-dose devices — and remember that nasal devices are never shared between people.

Step-by-step: nasal sprays and drops

Sprays:

  1. Verify the person, medication, dose, route, time, and nostril(s) per the order.
  2. Perform hand hygiene; gloves per policy. Blow the nose gently to clear the passages (per the order/instruction).
  3. Shake the bottle per label, prime if needed, and clean the tip per the product's instructions.
  4. Position: seated or standing, head upright and tilted slightly forward, so the spray rises into the nasal passages rather than running down the throat.
  5. Place the tip just inside the nostril, aiming away from the septum (toward the outer wall).
  6. Spray while the person breathes in gently — a normal, soft sniff, not a hard one.
  7. Repeat in the other nostril if ordered. Replace the cap; wipe the tip per product instructions.
  8. Document the medication, dose, nostril(s), time, and response.

Drops:

  1. Verify as above; perform hand hygiene and position the person seated with the head tilted back (or supine with the head over the edge of the bed, per facility policy), so the drops can reach the back of the nasal passages.
  2. Instill the ordered number of drops into each nostril as ordered, without touching the dropper tip to the nose.
  3. Keep the head tilted for a short time (per product/order) so the drops stay in place rather than dripping out.
  4. Document.

Assessment, teaching, and safety

Before: assess nasal congestion, discharge, and any history of frequent nosebleeds, nasal surgery, or septal problems; verify the nostril(s) in the order. Teach: aim away from the septum, sniff gently, clean the tip, never share the device, and use decongestant sprays only as directed (long-term daily use can cause rebound congestion — advise the person to discuss duration with their provider). Report: persistent nosebleeds, pain, or worsening congestion. Document the administration and the response.

Common Confusions

Do Not ConfuseWithDifference
Sniffing gentlySniffing hardA hard sniff pulls the dose down the throat; a gentle sniff lets it coat the nasal mucosa.
Aiming at the outer wallAiming at the septumThe septum is delicate — repeated spraying on it can cause irritation and nosebleeds.
Head position for spraysHead position for dropsSprays: head upright, tilted slightly forward. Drops: head tilted back so drops reach the nasal passages.
Priming a new pumpUsing it straight out of the packageUnprimed pumps may deliver a partial first dose; prime per the manufacturer.
Sharing a nasal deviceSharing an oral medication cupNasal tips contact mucosa and can transfer organisms — devices are never shared between people.
A decongestant spray used brieflyOne used daily for weeksShort-term use relieves congestion; prolonged daily use can cause rebound congestion — duration should follow the provider's direction.
Eli, the EliExplains learning guide

Eli explains

The same idea, in plain words

Explain it like I’m 10

Your nose is lined with a warm, wet blanket full of tiny blood vessels — that blanket is where the medicine should land. If you spray the middle wall of your nose, it hurts; if you sniff too hard, the medicine slides down your throat. So you aim to the side and take a gentle sniff, like smelling a flower.

Worked example

A person with seasonal allergies is being taught to use a new nasal corticosteroid spray — a metered-dose pump — one spray in each nostril daily. The nurse demonstrates: blow the nose gently, shake the bottle, prime the new pump with a few sprays into the air, then hold the bottle with the tip just inside the right nostril, aiming slightly toward the outer wall and away from the septum. "Take a gentle sniff — like you're smelling a flower — as you press the pump," the nurse says. The person tries it and sniffs hard; the nurse notices the medication taste at the back of the throat and corrects the technique: "That hard sniff pulls it down your throat — a soft breath in lets it coat the inside instead." After two practice sprays, the person gets it right. The nurse teaches them to wipe the tip and replace the cap after each use, not to share the device, and to tell their provider about nosebleeds or persistent irritation, then documents the administration and teaching.

Key takeaways

  • The target is the nasal mucosa on the outer wall (over the turbinates), not the septum.
  • Aim the spray away from the septum and sniff gently — a hard sniff sends the dose down the throat.
  • For sprays, the head tilts slightly forward; for drops, the head tilts back.
  • Prime new pumps per the manufacturer so the first spray delivers a full dose.
  • Never share nasal devices between people; clean the tip per product instructions.
  • Overuse of decongestant sprays can cause rebound congestion — a key teaching point about duration of use.
  • Verify the order: one nostril, both nostrils, and whether the effect is local or systemic.
  • Nasal mucosa absorbs into the bloodstream — nasal medications can have systemic effects.

Check yourself

6 review questions from the chapter. Try each one, then open the answer.

  1. Where should a nasal spray be aimed inside the nostril, and why?

    Show answer

    Toward the outer wall of the nasal passage, away from the septum. The septum is delicate, and repeated spraying on it can cause irritation and nosebleeds; the outer wall carries the turbinates, which provide most of the mucosal surface.

  2. What should the person do with their breathing as the spray is activated?

    Show answer

    Breathe in gently through the nose — a soft sniff, not a hard one — so the dose coats the mucosa instead of being pulled down the throat.

  3. How does the head position differ for nasal sprays versus nasal drops?

    Show answer

    Sprays: head upright and tilted slightly forward. Drops: head tilted back (or supine per policy) so the drops reach the nasal passages.

  4. Why is a new metered-dose pump primed before the first use?

    Show answer

    Priming (a few test sprays per the manufacturer) fills the pump mechanism so the first dose is a full, measured dose instead of a partial one.

  5. A person says they have used a decongestant spray daily for months and their nose feels more congested than ever. What concept does this illustrate, and what should you do?

    Show answer

    This illustrates rebound congestion — nasal congestion that worsens as a decongestant wears off after prolonged use. Acknowledge the problem, teach that duration of use should follow the provider's direction, and encourage them to discuss the medication with their provider.

  6. What should you verify in the order before administering a nasal medication?

    Show answer

    Right person, right medication, right dose, right time, right route, and which nostril(s) — one, both, or a specific side — plus the discard date on the device.

Keep learning

Ready to build on this? Continue to the next lesson.

Study tools & related lessonsKey vocabulary · Related

Key vocabulary

nares
The nostril openings
nasal septum
The midline wall that divides the nose into two passages
turbinates
Curved, shell-like ridges on the outer walls of the nose
nasal mucosa
The moist, blood-rich lining of the nasal passages
metered-dose spray
A pump device that delivers one measured dose per activation
priming
Activating a new or unused pump a few times per the manufacturer
rebound congestion
Worsening nasal congestion after a decongestant wears off

Sources & references

  1. openstax.org — Clinical Nursing Skills

This lesson was adapted from the open educational references above; their licenses and attributions are preserved. See Copyright & Licensing.

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