Wednesday, August 8, 2012

Pathophysiology - Otitis Media

OTITIS MEDIA
  • inflammation or infection in the middle ear
  • clients may have acute or chronic forms of either serous otitis, or the purulent or suppurative type
Causes
  • Serous otitis media
    • a collection of pathogen-free fluid behind the tympanic membrane
    • results from irritation associated with respiratory allergies and enlarged adenoids
  • Purulent otitis media
    • results from the spread of microorganisms from the Eustachian tube to the middle ear during respiratory infections
Potential complications
  • Mastoiditis
  • Labyrinthinitis
  • Brain abscess
Clinical findings
  • History of upper respiratory tract infection or seasonal allergies
  • Tinnitus
  • Fever
  • Sever earache
  • Diminished hearing
  • Bulging or perforation of the eardrum
Therapeutic management
  • Antibiotics
  • Symptomatic relief with analgesics, antihistamines, decongestants
  • Myringotomy – incisional opening of the eardrum to drain the purulent material
  • Myringoplasty – repair of the perforated eardrum
Nursing Management
  • Obtain a specimen of exudates for culture and sensitivity
  • Administer antibiotics and other medications as prescribed
  • Instruct clients how to administer eardrops
  • Monitor temperature, drainage, pain and hearing acuity to evaluate effectiveness of therapy
  • Instruct client to report headache or stiff neck immediately

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