Symptoms Acute otitis media: • Mild to severe pain in the affected ear • Fever • Diminished hearing • Dizziness • Vertigo • Tinnitus • Pus in the mastoid air cells often causes mas ... toid tenderness. • Tympanometry or air insufflation (blowing air into the ear) may reveal decreased movement of the tympanic membrane. • Tympanic membrane rupture, or perforation, may release a purulent discharge. • Myringotomy (surgical incision of the tympanic membrane) may be performed to relieve the pressure. Recurrent acute otitis media: • Refers to repeated incidences of acute otitis media, such as three in 6 months or four in 12 months. Serous otitis media: • Fluid in the middle ear without inflammation • Reported sensation of “snapping” or “popping” and acute hearing loss in the affected ear • May cause severe vertigo (sensation of whirling or rotation) • Sometimes becomes chronic (continuing for more than 3 months) and is more often linked to development of sensory hearing loss Risk Factors Otitis media occurs more frequently during winter months. Certain factors may increase a child’s risk for developing otitis media, including: • Allergies • Attendance at child care centers • Exposure to tobacco smoke • Pacifier use, which can alter dental structure and lead to eustachian tube dysfunction, as well as promoting reflux of nasopharyngeal secretions into the middle ear from sucking2 • Enlarged adenoids or edema from allergic rhinitis, which can cause eustachian tube obstruction • Preexisting Down syndrome or cleft lip and palate (which are associated with eustachian tube dysfunction). Factors that may help decrease the risk for developing otitis media include: • Avoiding putting children to bed with a bottle • Positioning infants upright for feeding • Breastfeeding, which appears to be protective against otitis media. In pediatric clients, typical manifestations of acute otitis media include: • Acute onset of ear pain • Middle ear effusion • Diarrhea • Omitting • Fever • Marked redness of the tympanic membrane on otoscopy. 3 Infants and young children who have otitis media may demonstrate: • Pulling at the ear, which is a sign of ear pain • Irritability and “acting out,” which can be reflective of a related hearing impairment • Awakening crying at night due to increased ear pressure when prone or supine. Native American and Native Alaskan children may demonstrate an increased risk for the development of otitis media. Treatment Pharmacologic therapies may be indicated for inclusion in the plan of care for clients who are experiencing otitis media. Select each bold item to learn more about medications used for otitis media. [Show More]
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