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