4 Otitis Media Nursing Care Plans


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:

  1. Acute Pain
  2. Disturbed Sensory Perception: Auditory
  3. Deficient Knowledge
  4. Risk for Infection

Risk for Infection

Nursing Diagnosis

May be related to

  • Knowledge deficit about infection in children

Possibly evidenced by

  • Ear pain
  • Irritability
  • Pulling on ears

Desired Outcomes

  • Child will remain free from further infection and complications from otitis media.
Nursing InterventionsRationale
Advice family members on handwashing techniques and the importance of covering their mouths and noses when sneezing or coughing.Proper hygiene prevents spread of
Encourage increased fluid intake, good nutrition, and adequate rest.Decreases susceptibility to infection.
Limit visitors and avoid exposure to people with existing upper respiratory infections.Other people can spread infections or colds to a susceptible patient through direct contact, contaminated objects, or through air currents.
Eliminate allergens and airway irritants such as tobacco, smoke, and dust.Passive smoking contributes to increase
the incidence of otitis media.
Place the infant in an upright position when feeding. Do not prop bottles.Elevated position prevents injection of milk and pathogens into the eustachian tube
If infection occurs, teach the patient to take antibiotics as prescribed. Instruct patient to take the full course of antibiotics even if symptoms improve or disappear.Completing the duration of the prescribed antibiotics lessens the chance for growth
of a microorganism. Not completing the prescribed antibiotic regimen can lead to drug resistance in the pathogen and reactivation of symptoms.


Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other nursing care plans for pediatric conditions and diseases:

Paul Martin is a registered nurse with a bachelor of science in nursing since 2007. Having worked as a medical-surgical nurse for five years, he handled different kinds of patients and learned how to provide individualized care to them. Now, his experiences working in the hospital is carried over to his writings to help aspiring students achieve their goals. He is currently working as a nursing instructor and have a particular interest in nursing management, emergency care, critical care, infection control, and public health. As a writer at Nurseslabs, his goal is to impart his clinical knowledge and skills to students and nurses helping them become the best version of themselves and ultimately make an impact in uplifting the nursing profession.
    • Thank you for your comment Meriga! I sure do hope you achieve your dream of becoming a nurse educator! Good luck, future clinical instructor! :)

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