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DISORDERS OF THE EXTERNAL EAR (ORTITIS EXTERNA (SIGNS AND SYMPTOMS (Ear…
DISORDERS OF THE EXTERNAL EAR
ORTITIS EXTERNA
PATHOPHYSIOLOGY
The result is either an allergic response or inflammation with or without infection.
An inflammation & infection of the external auditory canal
is a painful condition caused when irritating or infective agents come into contact with the skin of the external ear.
SIGNS AND SYMPTOMS
Ear canal - erythema and edema (sometimes severe)
Purulent exudate common
a discharge of liquid or pus from the ear
pain, tenderness or pulling of the pinna, redness and itching of the skin lining of the ear
some degree of temporary hearing loss
CAUSES
Polluted water exposure
a middle ear infection (otitis media) – discharge produced by an infection deeper in the ear can sometimes lead to otitis externa
irritation or an allergic reaction – otitis externa can occur because of a reaction to something that comes into contact with your ears, such as ear medication, ear plugs, shampoo or sweat
seborrhoeic dermatitis – a common skin condition where the naturally greasy areas of your skin become irritated and inflamed, which can sometimes affect the ears
mechanical trauma (scratching or injury from a foreign body)
NURSING CARE PLAN
NURSING INTERVENTION
dry swabbing – this gently mops out earwax from your ear canal
gently remove any discharge, earwax or debris from your outer ear using a twist of cotton wool
warm the ear drops by holding them in your hands for a few minutes, as cold ear drops can make you feel dizzy
encourage a patient to remove anything from your affected ear that may cause an allergic reaction, such as hearing aids, ear plugs and earrings
teach the patient to avoid getting your affected ear wet
give antibiotic ear drops – this can treat an underlying bacterial infection
DEFINATION
refers to an infection of the ear canal, the tube leading from the outside opening of the ear in towards the ear drum.
perichondritis
PATHOPHYSIOLOGY
Perichondritis is an infection of the perichondrium, a tough, fibrous tissue layer that surrounds the cartilage and shapes the pinna.
This tissue supplies blood to the ear cartilage. Infection can be caused by opening an area of pus or localized infection,
SIGNS AND SYMPTOMS
redness
swelling of the pinna
pain
fever (in severe cases)
deformation of the ear structure (in severe cases)
sudden hearing loss
abscess may be formed
CAUSES
Trauma
Insect bites
Ear piercings through the cartilage
Systemic inflammatory conditions (eg, vasculitides such as granulomatosis with polyangiitis, relapsing polychondritis)
Incision of superficial infections of the pinna
poorly treated otitis externa (swimmer's ear)
NURSNG INTERVENTION
a wide incision is made and suction drainage is used to remove pus and other fluid.
systemic antibiotic therapy
always Wash your hands.
application of soothing heat
inform thepatient about the disease process and possible outcomes
refer the patient to speech and hearing therapy if there is loss of hearing
promote comfort, offer emotional support and involve the patient's family and significant others
DEFINATION
Inflammation of the perichondrium.
CERUMEN IMPERFECTION
PATHOPHYSIOLOGY
Cerumen (wax) is the most common cause of an impacted canal. A canal can also become impacted as a result of foreign bodies that can enter or be placed in the external ear canal,
CAUSES
Hearing aid and earplug users are also more prone to earwax blockage.
use of Q-tips (and other objects such as bobby pins and rolled napkin corners), which can remove superficial wax but also pushes the rest of the wax deeper into the ear canal.
SIGNS AND SYMPTOMS
ear pain,
itching,
may experience a sensation of fullness in the ear, with or without hearing loss,
dizziness,
bleeding from the ear.
tinnitus, which is a ringing or buzzing in the ear
NURSING INTERVENTION
A nurse should soften the earwax by instilling prescribed drops.
teach a patient not to try and clean the ears with with cotton-wool buds, as it impacts the wax further
a nurse should ensure that the wax that is on the tympanic membrane must only be removed by the physician or professional nurse
teach the patient to avoid getting water into the ear during swimming
assess the tympanic membrane perforation
when there is tympanic perforation a nurse should ensure that irrigation is not done because water may get into the middle ear and cause eardrum damage
DEFINATION
a condition in which earwax has become tightly packed in the external ear canal to the point that the canal is blocked
EAR ABSCESS/FUNCULOSIS
PATHOPHYSIOLOGY
A boil, also called a furuncle, is a deep folliculitis, infection of the hair follicle. It is most commonly caused by infection by the bacterium Staphylococcus aureus, resulting in a painful swollen area on the skin caused by an accumulation of pus and dead tissue.
CAUSES
water may be trapped during swimming and may change the flora of the external canal to produce infection
the warm, dark environment of the ear cal provides good medium for the growth of mocro-organisms.
he trauma may br caused by pricking the ear with a sharp object e.g. match stick which cauises break in the skin
SIGNS AND SYMPTOMS
swollen lymph nodes,
fatigue
an individual may experience fever,
tender, warm, and very painful
severe pain and hearing loss
bumpy, red, pus-filled lumps around a hair follicle
NURSING INTERVENTION
administer antibiotics as pescribed according to the culture result
surgical incision
wound care should be done
drainage
aseptic technique should be maintain
relieve enxiety by explaining the disease process and outcomes
DEFINATION
this is a localised form of infection that usually occurs following the infection of a hair follicle