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.
Nursing Care Plans
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:
Deficient Knowledge
Nursing Diagnosis
May be related to
- Lack of information
- Lack of recall of information
- Misinterpreted information
Possibly evidenced by
- Parents allow smoking in the home so child is exposed to passive smoke
- Infant is bottle-fed and sometimes the infant lies flat with the bottle propped
Desired Outcomes
- Parents will gain knowledge about prevention of Otitis Media.
Nursing Interventions | Rationale |
---|---|
Assess parent’s current knowledge on the condition, the risks of exposing the infant/child to passive smoking, feeding activities with the infant, and exposure to illness. | Provides baseline information about the parent’s awareness. |
Explain possible causes of OM: exposure to illness of others, irritation from environmental smoke, or formula entering the eustachian tube when the infant is fed in a supine position. | Provides information about health promotion. |
Provide privacy for discussion, promote trust, remain nonjudgmental, and support parents. | Shows respect for the parents and opens communication. |
Teach parents (and child if age- appropriate) about OM using an ear model for demonstration. Ask parents to verbalize their understanding of teaching. | Provides information by auditory and visual means and assesses understanding. |
Provide praise for decisions that will promote wellness for the child and lifestyle. | Positive reinforcement supports the decision to improve family. |
Refer parents to specialized class such as caregiving, smoking cessation, or parenting skills as needed. | Encourages follow-up and gaining additional knowledge and skills. |
Assist parents to plan measures to decrease the chances of recurrent OM such as completing the course of antibiotic, avoiding exposure to persons with infection, maintaining a smoke-free environment, and feeding the infant in a sitting position. | Allow parents to make good parenting decisions for their child to help prevent OM. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use. - Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively. - NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales. - Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates. - Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing. - Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans. - Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you. - Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023. - All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans for pediatric conditions and diseases:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Rheumatic Fever | 4 Care Plans
- Apnea | 4 Care Plans
- Brain Tumor | 3 Care Plans
- Bronchiolitis | 5 Care Plans
- Cardiac Catheterization | 4 Care Plans
- Cerebral Palsy | 7 Care Plans
- Child Abuse | 4 Care Plans
- Cleft Lip and Cleft Palate | 6 Care Plans
- Congenital Heart Disease | 5 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Croup Syndrome | 5 Care Plans
- Cryptorchidism (Undescended Testes) | 3 Care Plans
- Cystic Fibrosis | 5 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Dying Child | 4 Care Plans
- Epiglottitis | 5 Care Plans
- Febrile Seizure | 4 Care Plans
- Guillain-Barre Syndrome | 6 Care Plans
- Hospitalized Child | 5 Care Plans
- Hydrocephalus | 5 Care Plans
- Hypospadias and Epispadias | 4 Care Plans
- Intussusception | 3 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Kawasaki Disease | 6 Care Plans
- Meningitis | 7 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Osteogenic Sarcoma (Osteosarcoma) | 4 Care Plans
- Otitis Media | 4 Care Plans
- Scoliosis | 4 Care Plans
- Spina Bifida | 7 Care Plans
- Tonsillitis and Adenoiditis | 4 Care Plans
- Umbilical and Inguinal Hernia | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans
- Wilms Tumor (Nephroblastoma) | 4 Care Plans
Thank You for your impact in Nursing👏👏. I hope to be a nurse educator too
Thank you for your comment Meriga! I sure do hope you achieve your dream of becoming a nurse educator! Good luck, future clinical instructor! :)
Thank you for the information, I appreciate.
Helpful and very detailed
Thanks for the information I appreciate