Question

Otitis Media

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:

What else should you ask the client?

What teaching would you reinforce to prevent the recurrence of otitis media?

What expected outcomes would be specific to this situation?

Answer 1

The nurse must as the client about the risk factors and associated symptoms.

Ask about:

• Allergies: frequency and allergens
• A cold: blowing habits while having cold
• Flu
• Sinus infection
• Assess for infected or enlarged adenoids
• Exposure to cigarette smoke
• exposure to high levels of air pollution
• Recent travel with changes in altitude
• Experiencing changes in climate
• Cold climate
• having had a recent cold, flu outcome
• The family history of OM: genetics also plays a role in increasing the risk of Acute OM.

Check for associated symptoms: Common head and neck symptoms of AOM

• Otalgia – Characteristics of pain
• Otorrhea - Discharge from the ear due to perforation or rupture of the tympanic membrane
• A headache
• Symptoms associated with recent upper respiratory infection (URI)

Preventive teaching

Regular hand washing

Wash the toys regularly

Avoid exposure of cigarette smoke

Seasonal flu shots

Pneumococcal vaccines : help to fight the commonest causes of AOM, pneumococcus

Teach gentle blowing technique

Proper nutrition to improve general health

Avoid allergens

Outcome:

The outcome of AOM will vary depending on the severity of the disease.

AOM may resolve by its own in non-complicated cases without antibiotics

Regular follow up to assess for progression of the disease is necessary

Moderate to severe cases with the same degree of pain may be treated with antibiotic

The possible complications are: mastoiditis, cholesteatoma, labyrinthitis, facial paralysis, meningitis, epidural abscess, lateral sinus thrombophlebitis, brain abscess