Otitis Media (OM) is an infection of the middle ear (the space behind the eardrum) caused by bacteria or virus. It is the most common in infants and toddlers during the winter months. Inflammatory obstruction of the eustachian tube causes accumulation of secretions in the middle ear and negative pressure from lack of ventilation. The negative pressure pulls fluid and microorganisms into the middle ear through the eustachian tube resulting in otitis media with effusion. The illness usually follows a URI or cold. The older child runs a fever, is irritable, and complains of a severe earache, while a neonate may be afebrile and appear lethargic. The child may or may not have a purulent discharge from the affected ear.
Myringotomy is a surgical procedure performed by inserting tubes through the tympanic membrane to equalize the pressure inside. The tympanostomy tubes remain in place until they spontaneously fall out. Most children outgrow the tendency for OM by the age of 6. There is a higher incidence in children exposed to passive tobacco smoke and a decreased incidence in breast-fed infants.
The goal of nursing care to a child with otitis media include relief from pain, improved hearing and communication, avoidance of re-infection, and increased knowledge about the disease condition and its management.
Here are four (4) nursing care plans (NCP) and nursing diagnosis (NDx) for otitis media:
Disturbed Sensory Perception: Auditory
Disturbed Sensory Perception: Change in the amount or patterning of incoming stimuli accompanied by a diminished, exaggerated, distorted, or impaired response to such stimuli.
May be related to
- Inflammation and edema of middle ear
Possibly evidenced by
- Obstructed middle ear
- Child complains of not being able to hear
- Does not respond when spoken to
- Infant does not respond to sounds as usual
- Client will regain and improve hearing.
|Assess client’s hearing ability. Ask an older child to describe hearing loss (e.g., Is my hearing muffled in one ear? or is there|
an absence of sound in the affected ear?).
|Provides baseline evaluation regarding the degree of hearing loss.|
|Provide information about the condition and answer any inquiries. Reassure parents and child that hearing loss is not permanent and will resolve with treatment.||Decreases anxiety over a sensory loss.|
|Reduce unnecessary environmental noise.||The child may be confused and startled by sounds he or she cannot hear properly.|
|Encourage parents to speak in a loud and clear voice and look at the child when talking.||Assists the client to hear what is being said.|
|Administer antibiotics as prescribed.||When indicated for bacterial infection, a full 10-day course of an antibiotic is given to resolve otitis media and regain hearing.|
|Notify caregiver of changes in hearing ability or drainage from the affected ear.||Complications of OM may include perforation of the eardrum, mastoiditis, or conductive hearing loss.|
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