Page 1020 - Saunders Comprehensive Review For NCLEX-RN

Rationale: Acute otitis media is an inflammatory disorder caused by an infection
of the middle ear. The child often has fever, pain, loss of appetite, and possible ear
drainage. The child also is irritable and lethargic and may roll the head or pull on or
rub the affected ear. Otoscopic examination may reveal a red, opaque, bulging, and
immobile tympanic membrane. Hearing loss may be noted, particularly in chronic
otitis media. The child’s fever should be treated with ibuprofen. The child is
positioned on her or his affected side to facilitate drainage. A soft diet is
recommended during the acute stage to avoid pain that can occur with chewing.
Antibiotics are prescribed to treat the bacterial infection and should be administered
for the full prescribed course. The ear should not be irrigated with normal saline
because it can exacerbate the inflammation further. Antihistamines are not usually
recommended as a part of therapy.
Test-Taking Strategy: Focus on the subject, care for the child with acute otitis
media, and on the child’s diagnosis and note the words acute and right ear. Think
about the pathophysiology associated with the disorder and the associated
manifestations to select the correct options.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Planning
Content Area: Pediatrics: Eye/Ear
Health Problem: Pediatric-Specific: Acute and Chronic Otitis
Priority Concepts: Clinical Judgment; Infection
Reference: McKinney et al. (2018), pp. 1038-1039.

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