Page 1949 - Saunders Comprehensive Review For NCLEX-RN

perforation
d. Tender and enlarged postauricular
lymph nodes
e. Low-grade fever
3. Interventions
a. Prepare the client for surgical removal
of infected material.
b. Simple or modified radical
mastoidectomy with tympanoplasty is
the most common treatment.
c. Once infected tissue is removed, the
tympanoplasty is performed to
reconstruct the ossicles and tympanic
membrane in an attempt to restore
normal hearing.
4. Complications
a. Damage to the abducens and facial
cranial nerves; exhibited by an
inability to look laterally (cranial nerve
VI, abducens) and a drooping of the
mouth on the affected side (cranial
nerve VII, facial)
b. Meningitis
c. Brain abscess
d. Chronic purulent otitis media
e. Wound infections
f. Vertigo, if the infection spreads into the
labyrinth
5. Postoperative interventions
a. Monitor for dizziness.
b. Monitor for signs of meningitis, as
evidenced by a stiff neck and vomiting,
and for other complications.
c. Prepare for a wound dressing change 24
hours postoperatively.
d. Monitor the surgical incision for edema,
drainage, and redness.
e. Position the client flat with the
operative side up as prescribed.
f. Restrict the client to bed with bedside
commode privileges for 24 hours as
prescribed.
g. Assist the client with getting out of bed
to prevent falling or injuries from
dizziness.
h. With reconstruction of the ossicles via a
graft, take precautions to prevent
dislodging of the graft.

1949