Nursing Care Plan (NCP) for Otitis Media / Acute Otitis Media (AOM)

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Otitis Media Interventions (Picmonic)
Otitis Media Assessment (Picmonic)
Example Care Plan_Otitis Media / Acute Otitis Media (AOM) (Cheat Sheet)
Blank Nursing Care Plan_CS (Cheat Sheet)

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Hey everyone. Today, we are going to be feeling out a nursing care plan for otitis media or acute otitis media. So, let's get started. So, we're going to start off with the pathophysiology. So, otitis media is an infection of the middle ear behind the tympanic membrane or the ear drum that contains the tiny vibrating bones of the ear. Otitis media may be viral or bacterial, and depending on the cause, it's generally treated with antibiotics. Nursing considerations: you want to assess vital signs. You want to observe the ear and throat for pain, hearing, changes in speech, administer medications, prepare the patient for surgery and educate the family or care caregiver. The desired outcomes are that the patient will be free from pain and infection and the patient will have an optimal hearing. 

So, if we're going to go ahead and go through with our care plan, we're going to go through some of our subjective data and our objective data. So, what we're going to see in our patient. So, some very common subjective data is they're going to have ear pain and some hearing loss. Some objective data that you're going to see is tugging at the ear and a fever and lack of balance - if you remember that cranial nerve eight is also part of your balance. Other things are fussiness, irritability, a headache, fluid drainage from the ear, vomiting, and diarrhea. 

So, nursing interventions: one of the first things we're going to look for is we're going to monitor vital signs. So, pain and fever can increase the heart rate and also the blood pressure. Another thing we're going to be looking for is we're going to observe the ears in the throat for any sort of signs of drainage or discharge. So, congestion, maybe some postnasal drip, drainage of the ears that might be present when you're looking at the patient. Co-infections such as strep throat, a cold, or maybe the flu, can also be present with these patients. Another thing we want to assess is the patient's pain, making sure you're using the right pain scale. So, you want to use the faces or the numeric and get pain medication as needed. Another thing we're going to assess is that we're going to be assessing for any sort of hearing loss or changes in speech. So, sounds might be disordered, or they might be muffled in the affected ear. So, toddlers learning to talk, they may have changes in speech due to the impaired ability to hear properly. Another assessment that we want to be doing is we want to make sure that we're positioning the patient for comfort sitting up or lying down, making sure we're having them set up so that they have increased ability for breathing. But also, just to make sure that we're not keeping any of that from the pain from the ear, we want to give medication. So, we want to give any sort of antibiotics and or pain medication as we had talked about earlier. So, Tylenol may be given or any other methods such as applying a warm, not a hot, but a warm, moist compress to the affected ear. Antibiotics are usually given for bacterial infections. So, a full 10-day course is generally required, but you do not. One of the main things with antibiotics is you want to make sure that they do not stop taking, even if they feel better - you want to make sure you're telling the patient or the caregiver to complete the entirety of that antibiotic therapy. Another thing that we're going to want to be helping with the patient is possibly preparing them for a tympanostomy tube placement. So, this is going to allow that fluid to drain from the ear. Another invention to keep in mind is obviously some education for the caregiver or the parents. You want to make sure you're educating on any sort of follow up care that may be needed, because you want to keep in mind. Some of these infections may be restricted from certain antibiotics. So, you want to encourage them to get treatment and determine if the infection has cleared. If not, you may have to change course of treatment or have another treatment of antibiotics given. You want to avoid giving bottles or sippy cups because bottles and sippy cups enable the pain and are going to cause some issues. You want to make sure you're teaching them about good hand hygiene to avoid spreading the bacteria. 

So, some key points, some patho and etiology; infection of the middle ear can be viral, and it could be bacterial depending on the cause. It can be caused by allergies, a cold, sinus infection, very common or a small eustachian tube because children’s ears are more horizontal than diagonal. So, it's easy to have fluid buildup in that middle ear. That can cause an infection. Some subjective and objective: ear pain, fussing, irritability, headache, hearing loss, tugging and pulling at the ear. Very common with children are fever, fluid drainage from the ear, vomiting, diarrhea, lack of balance. You want to assess proper positioning. Assess vital signs, pain level, hearing loss, changes in speech, and ears and throat for drainage.  Position the patient for comfort. We want to give medication, surgery if needed. Give pain medication antibiotic therapy or apply a cold heat. Compress, prepare the patient for tympanostomy tube placement if needed and able to help with the drainage of the ear. 

Excellent job guys. We will love having you guys here. Go out, be your best self today and as always happy nursing.

 
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