Otitis Media

at
Categories
Tags

An 8-year-old girl comes to your ambulatory care clinic with complaints of left ear pain for the past 3 days. She had respiratory infection a week ago. On physical examination, the tympanic membrane is bulging.
Answer the following questions:
1. What else should you ask the client?
2. What teaching would you reinforce to prevent the recurrence of otitis media?
3. What expected outcomes would be specific to this situation?

 

 

Sample Solution

 

 

 

In addition to the ear pain, it’s important to ask the 8-year-old girl (and her parent/guardian) some additional questions to get a clearer picture of the situation:

  • Severity and Characteristics of Pain: How severe is the pain? Is it constant or throbbing? Does anything make it worse (lying down, chewing)?
  • Ear Drainage: Has there been any drainage from the ear (pus, blood)?
  • Hearing Changes: Has she noticed any difficulty hearing in the affected ear?
  • Fever: Has she had a fever in the past few days?
  • Allergies: Does she have any allergies, particularly to medications?
  • Past Ear Infections: Has she had any ear infections in the past?

2. Teaching to Prevent Recurrence of Otitis Media:

Here are some key points to reinforce to prevent recurrent otitis media (ear infection):

  • Reduce Exposure to Secondhand Smoke: Secondhand smoke exposure can irritate the Eustachian tube, which increases the risk of ear infections.
  • Frequent Handwashing: Proper handwashing helps prevent the spread of germs that can cause upper respiratory infections, which can lead to ear infections.
  • Treatment of Allergies: If allergies are present, managing them with medication can reduce congestion and the risk of ear infections.
  • Vaccinations: Ensure the child is up-to-date on all recommended vaccinations, especially those for influenza and pneumococcus, which can contribute to ear infections.
  • Proper Use of Decongestants (if prescribed): If decongestants are prescribed by the doctor, explain their proper use and potential side effects.
  • Avoiding Swimming While Draining: If the eardrum has ruptured, advise avoiding swimming or getting water in the ear until the doctor clears it.

3. Expected Outcomes:

Following appropriate treatment (which might include antibiotics and pain relievers), the expected outcomes for this situation include:

  • Reduced Ear Pain: The child’s ear pain should significantly improve within a few days of starting treatment.
  • Improved Hearing: If there was any hearing loss due to the infection, it should resolve as the infection clears.
  • No Fever: The child should be free of fever within a few days.
  • Normal Eardrum Appearance: Upon re-examination, the doctor should expect the tympanic membrane (eardrum) to appear normal without bulging.

Note: It’s important to remind the parent/guardian to follow-up with the doctor as instructed, even if the child seems to be feeling better. This ensures the infection has cleared completely and reduces the risk of complications.

This question has been answered.

Get Answer