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Diagnostic Evaluation Otitis media

  • The diagnostic evaluation of otitis media is based on history, physical examination, and otoscopy.
  • History: the nurse should obtain information about the onset, duration, frequency, and severity of symptoms; the presence of fever, ear pain, drainage, hearing loss, balance problems, or speech delay; the history of previous episodes of otitis media, upper respiratory tract infections, allergies, immunizations, or exposure to smoke or other irritants; the feeding method and position of infants; and the use of any medications or treatments.
  • Physical examination: the nurse should assess the general appearance and behavior of the child; the vital signs, especially temperature and respiratory rate; the lymph nodes of the head and neck for enlargement or tenderness; and the oral cavity for signs of infection or inflammation.
  • Otoscopy: the nurse should use a pneumatic otoscope to visualize the tympanic membrane and assess its color, contour, mobility, and transparency. The nurse should gently pull the pinna down and back for children under 3 years old and up and back for children over 3 years old. The normal tympanic membrane is pearly gray, concave, mobile, and translucent. The abnormal findings that indicate otitis media are:

Finding

Description

Type of Otitis Media

Redness

Increased blood flow due to inflammation

AOM

Bulging

Increased pressure due to fluid accumulation

AOM

Purulence

Presence of pus due to infection

AOM

Perforation

Rupture of the eardrum due to increased pressure

AOM

Drainage

Leakage of fluid or pus from the ear canal due to perforation

AOM

Orange discoloration

Presence of serous fluid due to chronic effusion

OME

Decreased mobility

Impaired movement due to fluid accumulation

OME

 

Questions on Diagnostic Evaluation Otitis media

Correct Answer is B

Explanation

The statement that "The risk factors for otitis media are not well-defined" is incorrect. The risk factors for otitis media are well-established, including factors like age (more common in children), exposure to smoke, attending daycare, and Eustachian tube abnormalities.

Correct Answer is D

Explanation

Passive smoking can increase the risk of otitis media. Exposure to secondhand smoke can cause irritation and inflammation in the Eustachian tubes, making individuals, especially children, more susceptible to ear infections.

Correct Answer is ["A","B","C"]

Explanation

The statement about the eardrum becoming red, swollen, and bulging due to the absence of effusion is incorrect. The presence of effusion behind the eardrum can cause it to appear red, swollen, and bulging, not the absence of effusion.

Correct Answer is C

Explanation

Skin rashes and allergic reactions are not mentioned as consequences of otitis media. Complications of otitis media primarily revolve around the auditory system and related functions.

Correct Answer is D

Explanation

Day care attendance is closely associated with an increased exposure to infectious agents, including the bacteria that can cause otitis media. Children in day care settings are in close contact with others, facilitating the spread of infections.

Correct Answer is ["B","D"]

Explanation

Otorrhea, which refers to discharge from the ear, is not a common symptom of AOM. Otorrhea is more commonly associated with chronic ear infections or other ear conditions but not necessarily with acute otitis media.

Correct Answer is A

Explanation

Immunization history of the child is important for the child's overall health, but it is not a specific symptom of otitis media. Immunizations do not directly influence the development or presence of otitis media.

Correct Answer is ["A","B","C","E"]

Explanation

Decreased mobility of the tympanic membrane can occur due to the accumulation of fluid in the middle ear, leading to impaired movement. This decreased mobility is often observed in acute otitis media and contributes to the diagnosis.

The eardrum appearing red and bulging is a typical finding in acute otitis media (AOM), not otitis media with effusion (OME). In AOM, the eardrum becomes red due to inflammation and bulges due to increased pressure from fluid buildup.

Inconsolable crying due to discomfort is a general symptom that can occur in children with various illnesses, including otitis media. While it indicates the child is in pain or discomfort, it is not a specific sign of hearing loss. Children may cry due to ear pain, but this symptom alone does not co

"I have no pain in my ear.”. Absence of ear pain is not consistent with otitis media. Otitis media is characterized by ear pain, especially in acute cases when there is inflammation and pressure in the middle ear. Lack of ear pain suggests the absence of this condition.

"I don't have a fever at all.”. The absence of fever is not consistent with acute otitis media. Fever is a common systemic response to infection and inflammation. In the context of otitis media, the presence of fever indicates a more severe or active infection.

Lip reading skills are not typically assessed in the context of otitis media. Otitis media primarily affects the auditory system, leading to hearing difficulties. While lip reading skills might be relevant for individuals with profound hearing loss, it is not a standard assessment for children with

The statement "I can balance perfectly" suggests that the child does not experience balance problems. This statement contradicts the typical symptoms associated with otitis media, which can include dizziness, unsteadiness, and balance issues. If the child can balance perfectly, it indicates that the

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