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The Child with Otitis Media



1. Pain related to inflammation and pressure on tympanic membrane NIC Priority Intervention: Pain Management: Alleviation or reduction in pain to a level of comfort acceptable to patient and family. The child or parent will indicate absence of pain.

NOC Suggested Outcome: Pain Level: Amount of reported or demonstrated pain.

Give analgesic such as acetaminophen. Use analgesic eardrops. Have the child sit up, raise head on pillows, or lie on unaffected ear. Apply heating pad or warm hot water bottle. Have the child chew gum or blow on balloon to relieve pressure in ear.

Analgesics alter perception or response to pain. Elevation decreases pressure from fluid. Heat increases blood supply and reduces discomfort. Attempts to open the eustachian tube may help aerate the middle ear.

Verbal child states that pain is relieved. Nonverbal child has improved disposition and comfort.

2. Infection related to presence of pathogens NIC Priority Intervention: Infection Control: Minimizing the acquisition and transmission of infectious agents The child will be free of infection.

NOC Suggested Outcome: Risk Control: Actions to eliminate or reduce health threats.

Encourage breastfeeding of infants. Instruct the parents to administer antibiotics exactly as directed and to complete prescribed course of medication. Telephone the parents 23 days after initial examination. Examine ear 34 days after completion of antibiotic treatment, or if symptoms worsen in child on symptomatic treatment.

Breastfeeding affords natural immunity to infectious agents. Taking antibiotics as prescribed minimizes chance for overgrowth of pathogens. If symptoms have not improved in 36 hours, treatment should be evaluated. Check-up determines if treatment is effective.

The childs temperature is normal, symptoms have disappeared, and tympanic membrane shows no signs of infection.

3. Risk for Caregiver Role Strain related to chronic disease NIC Priority Intervention: Caregiver Support: Provision of necessary support, information, and advocacy to facilitate care by parents. The parents will manage the childs condition with minimal stress.

NOC Suggested Outcome: Caregiver Performance: Provision by family care provider of health care for child.

Determine the parents ability to manage condition. Provide frequent information and feedback.

Many parents can treat children at home. Knowledge of condition allows parents to make informed decisions and to manage condition effectively. Active participation increases confidence and ability to manage condition. Reacting empathically encourages parents to communicate.

The parents express confidence about treating the child and state that stress is reduced.

Encourage parental input in managing care. Listen carefully to parental expressions of frustration and fatigue and try to understand parents feelings.




The Child with Otitis Media





4. Risk for Infection related to knowledge deficit about infection in children NIC Priority Intervention: Infection Control: Minimizing the acquisition and transmission of infectious agents NOC Suggested Outcome: Knowledge: Extent of understanding conveyed about infectious disease prevention.

The parents will state understanding of preventive measures.

Teach family members to cover mouths and noses when sneezing or coughing and to wash hands frequently. Have parents isolate sick children. Encourage optimal nutrition, rest, and exercise. Position bottle-fed infants upright when feeding. Do not prop bottles. Eliminate allergens and upper respiratory irritants such as tobacco, smoke, and dust.

Good hygiene prevents spread of pathogens.

Parents express understanding of measures to lead fewer to infections.

Physical well-being helps the body fight disease. Elevated position prevents injection of milk and pathogens into the eustachian tube. Fewer irritants and allergens may decrease susceptibility to respiratory infections. Secondhand smoke contributes to higher incidence of otitis media.

5. Risk for Altered Growth and Development related to hearing loss NIC Priority Intervention: Developmental Enhancement: Facilitating optimal growth and development of the child. The child will have normal hearing.

NOC Suggested Outcome: Growth and Development: Milestones of developmental progression.

Assess hearing ability frequently.

Monitoring detects hearing loss early. Early detection of developmental delays can lead to appropriate intervention.

The childs general health and hearing improve, and incidence of condition decreases. The child has language and motor development within norms for age group.

The child will have normal motor and language development.

Assess motor and language development at each health care visit.