Page 1010 - Saunders Comprehensive Review For NCLEX-RN

hours, symptoms include otalgia,
pruritis, fullness, drainage, and
impaired hearing.
b. A low-grade fever may be present.
c. Tenderness on manipulation of the
pinna and tragus is noted on physical
exam.
d. May have regional lymphadenopathy.
3. Interventions: Treatment is indicated with topical
antibiotics and may include neomycin with or
without polymyxin B or a fluoroquinolone
preparation.

To administer ear medications in a child younger than 3 years,

pull the earlobe down and back. In a child older than 3 years, pull the
pinna up and back.
F. Myringotomy
1. Description
a. A surgical incision into the tympanic
membrane to provide drainage of the
purulent middle ear fluid; may be
done by a laser-assisted procedure
b. Tympanoplasty tubes, which are small
cylinder-shaped tubes, may be inserted
into the middle ear to allow continued
drainage and to equalize pressure and
allow ventilation of the middle ear.
2. Postoperative interventions
a. Instruct the parents and child to keep
the ears dry.
b. The child should wear earplugs while
bathing, shampooing, and swimming
(diving and submerging under water
are not allowed).
c. Parents can administer an analgesic
such as acetaminophen or ibuprofen to
relieve discomfort after insertion of
tympanoplasty tubes.
d. Parents should be taught that the child
should not blow her or his nose for 7 to
10 days after surgery.

e. Instruct the parents that if the

tubes fall out, it is not an emergency,
but the PHCP should be notified;
inform the parents of the appearance

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