CONDITIONS OF THE MIDDLE EAR
ACUTE OTITIS MEDIA
Assessment and common findings
nursing management
Pathophysiology
Causes
essential health education
Definition
Chronic otitis media
pathophysiology
definition
Otoslerosis
pathophysiology
assessment and common finings
definition
management
Mastoiditis
clinical manifestations
assesssment and common findings
pathophysiology
management
definition
is an infection and inflammation of the middle ear.
The condition is caused by various types of bacteria, for instance Streptococcus pneumoniae.
The infection is usually related to respiratory tract infection or allergic reactions
In respiratory infections, the infective organisms ascend along the Eustachian tube into the middle ear.
The inflammatory reaction caused by this results in the Eustachian tube becoming swollen and blocked, which results in a negative pressure in the middle ear.
Fluid stagnates because there is no drainage, the movable joints of the ossicles become immovable, and transmission of sound waves is not possible.
As the inflammatory process advances, fever increases and hearing decreases.
allergic swelling of the throat and dysphagia
Purulent discharge indicative of eardrum perforation
tonsillitis,
dysphagia
cold
administering analgesics as pescribed to relieve pain e.g. paracentamol
if the ear descharges it should be kept dry by wicking
administer antibiotics to clear infection such as amoxycillin
he/ she sjpuld take the pescribed analgesics
The patient should complete the prescribed course of antibiotics to clear the infection
the patient must be taught hoiw to wick the ear
Untreated acute otitis media becomes chronic if the infection has not cleared and continues for more than two weeks
management
causes
Recurrent acute otitis media with increased virulence of infecting organisms
Inadequate drainage through the eustachian tube, especially where upper respiratory infections are a current factor
Pharyngeal congestion and lowered immune status
Tuberculosis
HIV infection
health education
The nurse should carefully dry the ear by wicking
Broad spectrum antibiotic ear drops preparations may be instilled as prescribed, and in the case of a child, oral antibiotics may be prescribed for five days with a follow-up after two weeks
The patient must be taught how to wich the ear
The use of commercially available cotton ear buds should be discouraged, because these can perforate the tympanic membrane.
The patient should not insert or instill anything into the ear except that which has been prescribed.
The course of prescribed antibiotics must be completed so that the patient does not develop any resistance
The inside of the ear must be kept dry, therefore the ear must be protected from getting wet when shampooing hair, showering or swimming.
The patient must keep follow-up appointments, check and report any painful swelling behind the ear, which indicates mastoiditis
This is a condition where the moveable joints between the ossicles in the middle ear are fixed, or their mobility is reduced significantly
There may also be a history of deafness in the family
loss of self esteem and irritability
There is a history of progressive hearing loss even though the external ear canal and eardrum are normal
In respiratory infections, the infective organisms ascend along the Eustachian tube into the middle ear.
The inflammatory reaction caused by this results in the Eustachian tube becoming swollen and blocked, which results in a negative pressure in the middle ear.
Fluid stagnates because there is no drainage, the movable joints of the ossicles become immovable, and transmission of sound waves is not possible.
As the inflammatory process advances, fever increases and hearing decreases.
There is a progressive loss of stapes movement due to the formation of sclerotic bone, which fixes the stapes foot plate onto the oval window. The stapes becomes immobile causing a conductive hearing loss.
caises
infectious
genetics
autoimmune
refer the patient for audometric testig in order to get a hearing aid
communicating with the patiens when there is speech and language problems
infection and inflammation of the mastoid air cells as a result of recurrent chronic otitis media
In otitis media, infection drains into the mastoid resulting in increased exudate.
Excessive drainage from the mastoid cavity traverses through the middle ear and out of the perforated tympanic membrane through into the external auditory canal.
The inflammatory process in the mastoid air cells results in oedema and more exudate, thus increasing the pressure in the bony cavity
pain is severe and purulent ear discharge may be profuse
on palpation there is swelling and tenderness over the mastoid process
otalgia, ottorrheao and impared hearing
te pinna protrudes indicatind oedema
there is history or recurrent otitis media with or without cholesteatoma
mastiod process is tender on palpation
administer analg4sics to relieve pain
surgery
administer antibiotics to combat infection