A 20 year old male patient reports loss of interest and depressed mood during his appointment. The nurse would utilize what screening tool to further evaluate the patient?

A. The purpose of the tubes is to decrease the pressure and allow for drainage: Tympanostomy tubes are placed in the tympanic membrane to facilitate drainage of middle ear fluid and equalize pressure. They help prevent recurrent otitis media and improve hearing in children prone to persistent effusions. The tubes create a temporary opening that allows air to enter the middle ear, reducing the risk of fluid accumulation and infection.

B. The tubes are permanently inserted during a surgical procedure: Tympanostomy tubes are not permanent; they usually fall out on their own within 6 to 12 months as the tympanic membrane heals. In some cases, if they do not extrude naturally, they may need to be removed by an ear, nose, and throat (ENT) specialist. Permanent tubes are rarely used and only in cases of severe chronic ear problems.

C. The tubes are placed in the inner ear: Tympanostomy tubes are inserted into the tympanic membrane (eardrum), which separates the outer ear from the middle ear. They do not enter the inner ear, which contains the cochlea and vestibular system. Placement in the inner ear would not be anatomically correct and could lead to serious complications.

D. The tubes are used in children with sensorineural loss: Tympanostomy tubes are not a treatment for sensorineural hearing loss, which results from damage to the inner ear or auditory nerve. They are used for conductive hearing issues caused by middle ear effusion, recurrent ear infections, or Eustachian tube dysfunction. Sensorineural hearing loss is typically managed with hearing aids or cochlear implants, not tympanostomy tubes.

A. Once the speculum is in the ear, releasing the traction: Releasing traction too soon can lead to collapse of the ear canal, obstructing the view of the tympanic membrane. Maintaining traction throughout the examination ensures a clear view and prevents discomfort.

B. Pulling the pinna up and back before inserting the speculum: The correct technique for an adult involves pulling the pinna up and back to straighten the external auditory canal, allowing for an unobstructed view of the tympanic membrane. In children under three, the pinna is pulled down and back due to the more horizontal orientation of the ear canal.

C. Tilt the person's head forward during the examination: The head should remain upright or slightly tilted away from the examiner to provide better access to the ear canal. Tilting forward is unnecessary and may not improve visualization.

D. Using the smallest speculum to decrease the amount of discomfort: A speculum that is too small may not provide a sufficient view of the tympanic membrane. The largest speculum that comfortably fits should be used to allow for optimal visualization.