A nurse working on an outpatient surgical unit is providing discharge teaching to the parent of a preschooler following placement of tympanoplasty tubes. The parent asks the nurse, "What should I do if the tubes fall out?" Which of the following responses should the nurse make?
"Gently put the tubes back into the child's ears."
"Bring the child to the emergency department immediately."
"Notify the provider that the tubes have fallen out."
"The tubes are sutured in place and must be surgically removed."
The Correct Answer is C
A. "Gently put the tubes back into the child's ears": This is not the correct response. Tympanoplasty tubes are not meant to be reinserted if they fall out. Attempting to reinsert them without proper medical training could cause injury or damage to the child's ears. Therefore, this response should be avoided.
B. "Bring the child to the emergency department immediately": While it's important for the parent to seek medical attention if the tubes fall out, it may not always necessitate a visit to the emergency department, especially if the child is not experiencing any other symptoms. This response might cause unnecessary panic for the parent and may not be the most appropriate course of action.
C. "Notify the provider that the tubes have fallen out": This is the correct response. If the tympanoplasty tubes fall out, the parent should notify the healthcare provider who performed the procedure. The provider can then assess the situation and determine the next steps, which may include scheduling a follow-up appointment to evaluate the child's ears.
D. "The tubes are sutured in place and must be surgically removed": This is incorrect. Tympanoplasty tubes are not sutured in place; they are typically designed to fall out on their own after a certain period of time. Additionally, removal of tympanoplasty tubes usually does not require another surgical procedure.
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Related Questions
Correct Answer is A
Explanation
A. Pull the pinna down and back: This technique is appropriate for administering otic drops to an infant or young child. By gently pulling the pinna (outer ear) down and back, it straightens the ear canal, allowing the drops to enter more effectively.
B. Insert the dropper into the ear canal: This option is incorrect. It is essential not to insert the dropper directly into the ear canal, especially in young children, to prevent injury to the ear drum or ear canal.
C. Administer the ear drops at 5.5°C (42°F): The temperature at which the ear drops are administered is not typically specified in practice. Room temperature drops are generally recommended for patient comfort, but they do not need to be at a specific temperature.
D. Massage the area behind the ear: Massaging the area behind the ear after administering otic drops can help distribute the medication within the ear canal. However, it is essential to follow specific instructions provided by the healthcare provider regarding post-administration care.
Correct Answer is D
Explanation
A. FACES: The FACES pain scale is a visual analog scale commonly used with older children who can point to or select a facial expression that best represents their pain level. It may not be suitable for infants who may not have the cognitive or motor skills to use the scale effectively.
B. COMFORT: The COMFORT scale assesses pain in infants and young children based on behaviors such as crying, facial expressions, and body movements. It evaluates parameters such as alertness, calmness, respiratory response, physical movement, and muscle tone. The COMFORT scale is suitable for assessing pain in infants and young children, including those who are postoperative.
C. CRIES: The CRIES scale is a neonatal pain assessment tool that evaluates crying, oxygen saturation, vital signs, expression, and sleeplessness. While it is designed for newborns and infants up to 6 months of age, it may not be as appropriate for a 12-month-old infant who is postoperative and beyond the neonatal period.
D. FLACC: The FLACC scale assesses pain in infants and young children based on five behavioral categories: facial expression, leg movement, activity level, cry, and consolability. It is commonly used in pediatric settings and is suitable for assessing pain in infants who are postoperative.
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