Chapter 39: Nursing Care of the Child With an Alteration in Sensory Perception/Disorder of the Eyes or Ears

The parents of a 4-year-old boy tell the nurse, "We're really worried that our child doesn't have 20/20 vision. It seems that he doesn't always see clearly at a distance." What is the best response by the nurse? "We don't check a child's vision until they are 6 to 7 years old because their visual acuity hasn't peaked until then." "20/20 vision isn't usually achieved until the age of 6 or 7 years but I will let the physician know your concerns." "Until your child can read we can't check the visual acuity." "Vision continues to improve as the child ages. Hopefully you will notice improvement in your child's vision."

"20/20 vision isn't usually achieved until the age of 6 or 7 years but I will let the physician know your concerns." While 20/20 vision isn't usually achieved until the age of 6 or 7 years, it is important to notify the physician in case there is another cause for the lack of vision clarity. Visual acuity can be assessed prior to the child's ability to read.

A child has been diagnosed with bacterial conjunctivitis. Which statement(s) by the child's parent indicates the need for further education? Select all that apply. "All of us at home need to wash our hands really well." "I will continue to use eye drops until the redness is gone." "We should not use a towel that our child has used." "This is really contagious." "Our child can go back to school in 4 hours, after that thick yellow drainage is gone."

"I will continue to use eye drops until the redness is gone." "Our child can go back to school in 4 hours, after that thick yellow drainage is gone." Antibiotic eye drops or ointment should be used until the full course of treatment has been completed. The parent should not stop just because the redness is gone. The child can go back to school 24 to 48 hours, after the mucopurulent drainage is no longer present. The other choices are correct responses.

The nurse in the emergency department is caring for a child who has a simple contusion of the right eye following a motor vehicle accident. Upon discharge to home, which response by the parents requires further clarification? "Our child will probably have a black eye for at least a couple of weeks." "I will need to apply heat to the eye four times a day." "The blood in the white part of the eye is normal with this type of injury." "For the first 24 hours I will apply ice for 20 minutes, then leave it off for 20 minutes."

"I will need to apply heat to the eye four times a day." To decrease edema in the child with a simple contusion, instruct the parent to apply an ice pack to the area for 20 minutes, then remove it for 20 minutes, and continue to repeat the cycle as often as possible during the first 24 hours. Tell the parents and child that bruising of the surrounding eye area may take up to 3 weeks to resolve. Scleral hemorrhage is natural history of resolution without intervention over a period of a few weeks with this type of injury.

The nurse is obtaining the history from the parents of an infant who is suspected of having infantile glaucoma. Which statement by the parents would help to confirm this suspicion? "He opens his eyes quite frequently when he's awake." "It seems like bright lights really bother him." "His eye doesn't seem to tear much." "His eye looks about the same size as his other eye."

"It seems like bright lights really bother him." Photophobia occurs with infantile glaucoma, so bright light may bother the infant. Typically, the infant with infantile glaucoma will keep his eyes closed most of the time. The affected eye may appear enlarged with infantile glaucoma. Tearing is associated with infantile glaucoma.

The nurse is educating a 13-year-old paintball enthusiast about sports-related injuries. Which comment is most likely to be accepted by the child? "Play tough, but wear protective gear." "Paintball eye injuries have doubled in the past two years." "56% of paintball eye injuries have poor outcomes." "Most sports injuries happen to guys your age."

"Play tough, but wear protective gear." Every study cited shows that safety gear prevents injury. However, adolescents tend to ignore safety warnings. So, encouraging the child to play as tough as he pleases if he's wearing safety gear has the best chance of being heard. He won't pay attention to statistics.

The nurse is educating the parents of a 7-year-old boy who has hearing loss due to otitis media with effusion. Which statement by the parents indicates that further education is needed? "We need to face our son when we are speaking." "We need to raise the volume of our voices significantly so he can hear us." "Using hand gestures as visual cues should help our child understand a little better." "We need to make sure we are speaking clearly."

"We need to raise the volume of our voices significantly so he can hear us." It is not necessary for the parents to raise their voices more than slightly in order to be heard. Speaking clearly is an appropriate technique for communicating with the child. Facing the child when speaking is an effective method for communicating with the child. Using visual clues, such as hand gestures, is an effective technique for communicating with this child.

The parents of an 8-year-old child report that the child's teachers noted the child is having problems seeing the board in school but state they do not understand this since the child is able to read from the computer with no difficulty. Which response from the nurse is most appropriate? "What you are describing may be what is called myopia." "This may signal your child is having difficulty paying attention rather than a visual disorder." "Your child will need to be evaluated for an accommodation disorder." "These reports are consistent with hyperopia."

"What you are describing may be what is called myopia." Myopia (nearsightedness) occurs when light rays focus anterior to the retina, causing objects that are far away to be unfocused. Typically, this develops around age 8 years and then progresses. These children can read a book or a computer screen immediately in front of them but are unable to read the blackboard clearly from a distance. There is no indication that the child is experiencing issues with paying attention. This suggestion does not address the parent's initial complaint. Accommodation disorders present with complaints of diplopia and headaches. Hyperopia (farsightedness) presents with vision that is blurry at a close range and clear at a far range, which is opposite of what is being reported for this child.

The nurse recognizes that if the infant is following normal development, the infant will be able to focus and follow an object with the eyes by what age? 21 days of age 2 months of age 7 days of age 1 month of age

2 months of age Newborns are born nearsighted. They prefer the human face to other objects. At 1 month they can recognize by site the people they know. By 2 months of age, the infant can focus and follow an object with the eyes. Binocularity develops at 6 months and color vision follows at 7 months.

An infant is born with congenital glaucoma. The infant is scheduled for surgery to relieve this condition at age 2 days. Which prescription should the nurse question for the infant? Nothing by mouth (with intravenous therapy) prior to surgery A preoperative antibiotic A preoperative injection of atropine Arm restraints to be applied after surgery

A preoperative injection of atropine Glaucoma is caused by the obstruction of the aqueous humor flow and causes increased intraocular pressure. Atropine is a drug that causes pupil dilation and further narrows the exit of fluid. It would be contraindicated for this child. The other prescriptions would be appropriate for the child prior to surgery and in the postoperative period.

The 12-year-old child has developed a stye. Which may be included in the child's care? Apply hot, moist compresses to the affected area. Apply cool, dry compresses to the affected area. Apply petroleum jelly to reduce irritation. Manually express the lesion when a head forms.

Apply hot, moist compresses to the affected area. The stye is an infection of a ciliary gland (a modified sweat gland) that enters the hair follicle at the lid margin, most commonly caused by Staphylococcus. Management of the stye includes the use of hot, moist compresses. Manual expression is not indicated. Petroleum jelly will not be appropriate nor will it reduce inflammation. Cool, dry compresses will not be therapeutic. Heat provides for vasodilation, which will be useful in the resolution of the inflammation.

The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan? Assess vision to determine functional capability. Teach parents to make vinegar and alcohol eardrops. Assess the child's ability to convey information. Explain botulinum injection procedure and risks.

Assess the child's ability to convey information. Children who are unable to hear during the first 36 months of life are unable to learn the language necessary for normal verbal communication; therefore, it will be important to assess the child's ability to convey information. Visual assessment is not indicated. Educating parents about botulinum injections is an intervention for strabismus. Vinegar and alcohol eardrops are a treatment for swimmer's ear.

The nurse is teaching a group of parents about eyes and eye concerns. The nurse tells these caregivers about a condition that occurs when unequal curvatures in the cornea bend the light rays in different directions and this causes images to be blurred. The condition the nurse is referring to is: Astigmatism Refraction Myopia Hyperopia

Astigmatism Astigmatism is caused by unequal curvatures in the cornea that bend the light rays in different directions and produce a blurred image. Refraction is the way light rays bend as they pass through the lens to the retina. Myopia is nearsightedness; hyperopia is farsightedness.

A young child in the clinic has watery eyes and reddened conjunctiva. The child keeps the eyes closed a lot, because it hurts to have them open. Which problem does the nurse suspect for this client? Blepharitis marginalis Conjunctivitis Chalazion Stye

Conjunctivitis Conjunctivitis is inflammation of the conjunctiva and is demonstrated by watery eyes with reddened conjunctiva and sensitivity to light. Sticking of eyelids with pustular drainage is also a sign. It is very contagious and requires antibiotics for treatment. Blepharitis is a chronic scaling with discharge along the eyelid margin. A stye is a localized infection of the sebaceous gland of the eyelid. A chalazion is a chronic painless infection of the meibomian gland. The stye and blepharitis will require antibiotic treatment. A chalazion will clear on its own.

In children with otitis media, a procedure known as a myringotomy may be performed. Which statement is most accurate regarding this procedure? A small incision is made in the earlobe during this procedure. During this procedure, small tubes are inserted into the tympanic membrane. This procedure is performed as soon as otitis media is diagnosed. The purpose of this procedure is to decrease or stop the drainage.

During this procedure, small tubes are inserted into the tympanic membrane. Myringotomy (incision of the eardrum) may be performed to establish drainage and to insert tiny tubes into the tympanic membrane to facilitate drainage. The procedure is done for children with chronic otitis media, not as soon as the child is diagnosed.

The mother of a 4-week-old infant is discussing her baby's vision with the nurse. What information should be included? Select all that apply. Infants experience blurry vision due to the immaturity of their eye structures. Children will not have 20/20 vision until they are school age. Babies can focus on multiple images at birth. Your baby can see colors clearly. Your baby can see about 8 to 10 inches.

Infants experience blurry vision due to the immaturity of their eye structures. Your baby can see about 8 to 10 inches. Children will not have 20/20 vision until they are school age. The spherical shape of the newborn's lens does not allow for distance accommodation, so the newborn sees best at a distance of about 8 to 10 inches and a decreased number of cones further contributes to neonatal blurry vision. The optic nerve is not completely myelinated, so color discrimination is incomplete. Visual acuity develops over the first few years of the child's life. Visual acuity improves over the first few years of the child's life, with 20/20 achieved by age 6 or 7 years. The rectus muscles are uncoordinated at birth and mature over time so that binocular vision may be achieved by 4 months of age.

An 8-year-old boy comes to the emergency room with an eye injury after having a glass bottle shatter near his face. Which intervention should the nurse do first while assisting this client? Touch the glass fragment in the eye with a moistened, sterile, cotton-tipped applicator Grasp the eyelashes of the upper eyelid and evert it Instill a few drops of a topical anesthetic into the affected eye Press firmly on the lower lid with the fingertip until it turns out

Instill a few drops of a topical anesthetic into the affected eye Children who have eye injuries are usually in acute pain immediately after the injury. A few drops of a topical anesthetic instilled into the eye may be necessary to relieve the pain and allow the eye to be opened for examination. To visualize the inner surface of the lower lid and the bottom half of the eye globe, press firmly on the lower lid with your fingertip until it turns out. Grasp the eyelashes and gently stretch the upper eyelid downward. Place the stick of a cotton-tipped applicator horizontally against the center of the upper lid. While still grasping the eyelashes, pull the eyelid upward and over the applicator until it is everted. A foreign body, such as a speck of dirt or a fragment of glass, often clings to the inside of the upper lid and can be readily removed by touching it with a moistened, sterile, cotton-tipped applicator while the lid is everted.

A child returns to the clinic after an episode of external otitis (acute otitis externa or swimmer's ear) that has resolved. What would the nurse emphasize as the priority for preventing future episodes? Avoiding upper respiratory tract infections Performing handwashing Keeping ear canals dry Adhering to regular follow-up to assess for hearing loss

Keeping ear canals dry Since moisture contributes to external otitis (acute otitis externa or swimmer's ear), the priority is to keep the ear canals dry. Handwashing would be a priority for preventing infections such as conjunctivitis. Upper respiratory tract infections are associated with otitis media, not external otitis (acute otitis externa or swimmer's ear). Hearing loss is not associated with otitis externa.

The nurse is caring for a child who has conductive hearing loss. What is true regarding this type of hearing loss? It is caused by chronic otitis media or another infection. It is caused by maternal rubella. It is generally severe and unresponsive to medical treatment. It is often undetected until the child goes to school.

It is caused by chronic otitis media or another infection. In conductive hearing loss, the transmission of sound through the middle ear is disrupted. Structures fail to carry sound waves to the inner ear. Fluid fills the ear so the tympanic membrane is unable to move properly. This type of impairment most often results from chronic serious otitis media or other infection. Infants have hearing tests before being discharged from the hospital to determine hearing loss, especially premature infants. Hearing loss can be detected early because language development will be impaired. This type of hearing loss is treatable with the use of hearing aids, cochlear implants and communication devices. Rubella causes sensorineural hearing loss.

A nurse is assessing a child's vision. Which test should the nurse use to test for accommodation? Performing Hirschberg test Having the child touch the fly's wings in an image constructed of colored dots Performing a Weber test Moving a penlight toward the client's nose and observing whether eyes can follow it

Moving a penlight toward the client's nose and observing whether eyes can follow it To test for accommodation, ask a child (over 6 months of age) to follow a penlight as you move it in toward the nose. Children who cannot accommodate are unable to fuse their vision to follow a penlight toward their nose this way; instead, they demonstrate double vision (diplopia). The Stereo-Fly dot test, a test where the image of a fly is constructed from a series of colored dots, is used to test stereopsis. When asked to touch the fly's wings, a child with good depth perception touches them accurately. A child with poor depth perception touches a spot 2 or 3 inches above the pattern. Hirschberg test is used to detect true strabismus. The Weber test is a test for hearing.

The nurse is taking a health history for a 9-year-old child with conjunctivitis. Which finding would suggest that this is allergic conjunctivitis? Recently helped clean the basement Family history of conjunctivitis Exposure to infective agents Recent upper respiratory infection

Recently helped clean the basement Conjunctivitis may be classified as allergic, infectious or chemical. Allergic conjunctivitis may be induced by animal dander, dust mites, or some other ever-present antigen as might be found when cleaning unused spaces. Exposure to infective agents is related to infectious conjunctivitis. Recent upper respiratory infection and a family history of conjunctivitis are not contributing factors for allergic conjunctivitis.

A child with poor eye alignment cannot establish single binocular vision but has double vision. Which nursing action is most appropriate for this client? Ask if the child has had a computed tomography (CT) before Schedule the child for botulinum toxin injections Discuss surgical options for treatment Refer the child to a pediatric ophthalmologist

Refer the child to a pediatric ophthalmologist The nurse would refer the child experiencing diplopia (double vision) to a pediatric ophthalmologist for further testing; it is imperative to determine the cause to properly treat diplopia. Treatment may be as simple as eye exercises or glasses or could entail surgery. CT or magnetic resonance imaging (MRI) may be prescribed to assist in determining the cause. Knowledge of previous testing would not be a priority at this time. Botulinum toxin injections may be prescribed for treatment. Surgery may be discussed once the underlying cause is identified.

A 5-year-old child is diagnosed with acute otitis media. Which nursing intervention would be priority? Cautioning the child not to blow the nose Relieving the child's pain Cautioning the child not to pull on the ear Administering a mydriatic

Relieving the child's pain Acute otitis media is caused by a bacterial or viral infection of fluid in the middle ear. The fluid behind the eardrum has difficulty draining back out because of the horizontal positioning of the eustachian tube. This causes increased pain. Antibiotics are prescribed to cure the infection. Children need pain relief until the antibiotic prescribed reduces the inflammation and pressure. Children pull on the ear as an attempt to reduce the pain and equalize the pressure. Pulling on the ears, especially in an infant, is one of the first signs the parent sees to warn of the ear infection. Blowing the nose is also an attempt by the child to equalize the pressure in the ear and help reduce the pain. A mydriatic is a drug that induces dilation of the pupils.

A group of students are reviewing the various causes of bacterial conjunctivitis in children. The students demonstrate understanding of this condition when they identify what as the most common cause? Staphylococcus aureus Haemophilus influenzae Streptococcus pneumoniae Chlamydia trachomatis

Staphylococcus aureus S. aureus is the most common bacterial cause of conjunctivitis. Although a common cause, S. pneumoniae is not the most common cause of bacterial conjunctivitis. Although a common cause, H. influenzae is not the most common cause of bacterial conjunctivitis. Although a common cause, C. trachomatis is not the most common cause of bacterial conjunctivitis.

The school nurse is instructing the classroom teacher regarding a student newly diagnosed with amblyopia. To prepare for classroom instruction, which concept is most important for the nurse to convey to the teacher? There are no teaching methods that need to be considered. Student placement in the room is important but all other teaching methods may remain the same. Teaching sessions will need to be shortened due to eye strain. Hands-on learning should account for 90% of the teaching method.

Student placement in the room is important but all other teaching methods may remain the same. Amblyopia is when the vision in one of the eyes is reduced because the eye and the brain are not working together properly. The eye itself looks normal, but it is not being used normally because the brain is favoring the other eye. This condition is also sometimes called "lazy eye." The student can still see and, in some cases, has limited impairment due to brain compensation. It is associated with other conditions such as poor refraction, ptosis, cataracts, or strabismus. The child should be placed where he or she can be in direct view of the teacher or blackboard but the other teaching methods may remain the same. The methods do not need to be shortened nor does the child require a large percentage of the learning to be hands-on.

The nurse is reviewing the history and performing a physical assessment on a 6-week-old infant. The nurse notes glaucoma in the health care provider notes. Which physical assessment finding is congruent with the diagnosis? There is no red reflex Edema is present in the eyelids The right eye appears larger than the left The eyes are red and watering

The right eye appears larger than the left Enlargement of one or both eyes is a sign of infantile glaucoma. Red, watering eyes are a sign of an infection. The absence of a red reflex is a symptom of cataracts. This child is not old enough to rub the eyes and cause edema.

The nurse is caring for a 10-year-old girl with acute periorbital cellulitis. Which nursing intervention (therapy) is primary for this disorder? administering antibiotics IV as ordered administering morphine sulfate as ordered applying heated Aqua pad to site monitoring for increased intracranial pressure SUBMIT ANSWER

administering antibiotics IV as ordered Intravenous antibiotics will be the primary therapy for this child, followed by oral antibiotics. Warm compresses will be applied for 20 minutes every 2 to 4 hours. However, opioid analgesics are not necessary to handle the pain associated with this disorder.

When teaching a parent about amblyopia, it would be most important to explain that: amblyopia is a rapid irregular movement of the eye. if the child is not treated, he or she is likely to resent it later on. amblyopia is correctable if the child is properly treated before 6 years of age. amblyopia can result from a refractive error in one eye.

amblyopia is correctable if the child is properly treated before 6 years of age. Amblyopia is poor vision which develops in an otherwise structurally normal eye. With this condition the vision in one eye is decreased because the eye and the brain are not working together. The condition is known as "lazy eye" because one eye is stronger than the other. Amblyopia can be treated if discovered before 6 years of age. This is the reason early detection is so important. Strabismus, not amblyopia, is the rapid movement of the eye. Amblyopia is not caused by a refractive error in the eye. Telling the parent that if the child does not get treated, the child will resent it is not educating the parent. It is the nurse forcing judgment onto the parent, which should not happen.

The nurse is assessing the vision of 9-year-old boy. His vision appears normal on a vision screening test, although the nurse notices that he has to tilt his head occasionally as he is reading the chart. His mother tells the nurse that he has trouble reading and reports having a headache after doing his homework. Which condition should the nurse suspect in this boy? nystagmus astigmatism myopia amblyopia

astigmatism Astigmatism is an irregular curvature of the cornea, causing light to focus incorrectly on the retina resulting in an uneven quality of vision. On any given page of print, therefore, the child may see only half the letters or can have great difficulty reading or following written instructions. The child may report headache and vertigo after doing close work. Even though their vision appears deceptively normal on vision screening tests (they are able to see all of the numbers on a chart by tilting their head), these children need to be referred to an ophthalmologist on the basis of other problems such as vertigo, headaches, and difficulty with reading.

The nurse is assessing a 13-year-old boy with an eye injury. The nurse determines that evaluating pupillary response to light and accommodation is not appropriate based on the suspicion of a: corneal abrasion. scleral hemorrhage. foreign body. simple contusion.

scleral hemorrhage. Scleral hemorrhage appears as erythema in the sclera and can be quite large initially, but vision is unaffected by it. A simple contusion can affect visual acuity and may cause diplopia or blurred vision. Therefore, the nurse needs to check pupillary response. A foreign body can affect vision, necessitating evaluation of pupillary response. Corneal abrasion can affect vision. Therefore, the nurse should check the boy's pupillary response.

A child has recently been diagnosed with cataracts. The treatment for cataracts is: surgery. wearing a patch until the cloudiness clears. eye drops to lower the pressure. there is no treatment for childhood cataracts.

surgery. A cataract is marked opacity of the lens. It can be present at birth. Treatment for childhood cataracts is surgical removal of the cloudy lens, followed by insertion of an internal intraocular lens.

The nurse is providing immediate postoperative care for a 3-month-old who had a cataract removed. Which intervention would be the priority? instructing parents about using protective sunglasses explaining to the parents about patching the eye as therapy ensuring the protective eye patch is securely in place teaching the family how to use antibiotic eye drops

ensuring the protective eye patch is securely in place The priority intervention is to protect the operative site with an eye patch. Teaching about the use of protective sunglasses would be done later in the postoperative period in preparation for the child's discharge. Teaching the parents about administering eye drops would be done later in the postoperative period in preparation for the child's discharge. Explaining about eye patching would be done later in the postoperative period in preparation for the child's discharge.

The nurse is educating the parents of a 4-year-old boy with strabismus. Teaching for the parents would include the: importance of patching as prescribed. possibility that multiple operations may be necessary. need for ultraviolet-protective glasses postoperatively. importance of completing the full course of oral antibiotics.

importance of patching as prescribed. Teaching the parents the importance of patching the child's eye as prescribed is most important for the treatment of strabismus. The need for UV-protective glasses postoperatively is a subject for the treatment of cataracts. The possibility of multiple operations is a teaching subject for infantile glaucoma. Teaching the importance of completing the full course of oral antibiotics is appropriate to periorbital cellulitis.

The nurse is talking with the mother of a 4-year-old boy who will soon be going to a pre-kindergarten program. The child has had the Snellen vision test done at home, and he was unable to distinguish the pictures at the distance that would indicate his vision is normal. The child's mother asks the nurse if he will need glasses. Which statement made by the nurse would be most appropriate regarding the child's vision? "He is likely to have a slight astigmatism, which almost always needs to be corrected by glasses." "A child's vision is not completely developed by this age. Your child might outgrow this nearsightedness." "He might be suffering from hyperopia and probably will need glasses now." "His vision problem will get in the way of his learning, so he will probably have to have glasses before he starts school."

"A child's vision is not completely developed by this age. Your child might outgrow this nearsightedness." Visual acuity of children gradually increases from birth, when the visual acuity is usually between 20/100 and 20/400, until about 5 years of age, when most children have 20/20 vision. Hyperopia (farsightedness) is a refractive condition in which the person can see objects better at a distance than close up. Astigmatism is caused by unequal curvatures in the cornea that bend the light rays in different directions.

A toddler has been diagnosed with otitis media with effusion. The parents tell the nurse, "We really don't understand what that diagnosis means." How should the nurse respond? "There is an infection somewhere in the ear canal and their is fluid in the canal." "It's just a medical term that means an infection of the middle ear." "The diagnosis means unwanted fluid is within the middle ear space, and there may or may not be an infection present." "It would probably be best if you talked to the doctor again about the diagnosis."

"The diagnosis means unwanted fluid is within the middle ear space, and there may or may not be an infection present." Otitis media with effusion refers to the presence of fluid within the middle ear space, without signs or symptoms of infection. It may occur independent of acute otitis media (AOM) or may persist after the infectious process of AOM has resolved.

A parent believes the child will have a black eye. Which instruction is important for the nurse to provide this parent? Assure the parent that the scleral hemorrhages will resolve. Refer the child to an ophthalmologist for further evaluation. Place ice on the eye for 20 minutes/off the eye for 20 minutes for 24 hours. Administer acetaminophen if needed for pain.

Place ice on the eye for 20 minutes/off the eye for 20 minutes for 24 hours. A black eye is caused by a simple contusion to the eye. It affects the surrounding tissue of the eye but does not affect the eye itself. It produces swelling and bruising. It also causes scleral hemorrhage due to rupture of the blood vessels. The best treatment for the contusion is to place ice on for 20 minutes then off for 20 minutes for a 24-hour period. This helps reduce the swelling and pain. The bruising (the "black" eye) occurs from the vessels broken and leaking into the tissue. This may take about 3 weeks to go away. The nurse should assure the parent that scleral hemorrhages are benign but may take several weeks to resolve. The child would not need to be referred to an ophthalmologist unless the vision is impaired. Acetaminophen can be given for pain, but it is not the most important form of treatment for the problem.

The nurse is caring for a child who has had persistent otitis media effusions and is scheduled to have pressure equalizing tubes placed in 3 days. What should the parents observe after the tubes have been placed? improvement of the child's language and speech development decreased ability for the child to hear constant fluid draining from the child's ears slow increases in language development

improvement of the child's language and speech development Pressure equalizing tube placement allows for adequate hearing resulting in improvement of speech development and rapid increases in language acquisition. The drainage should not be constant, and parents should be instructed to call their health care provider if drainage is noted

The nurse is caring for a toddler who is scheduled to have myringotomy tubes placed. Which statement by the child's parents indicates a lack of understanding? "Hearing loss after the tubes are placed may be permanent." "Swimming is permissible only with ear plugs in place." "The tubes tend to fall out in 6 to 12 months." "My child should only shower with ear plugs in place."

"Hearing loss after the tubes are placed may be permanent." Myringotomy tubes can be placed in one or both ears as an ambulatory procedure after the local injection of lidocaine. Tubes tend to be extruded after 6 to 12 months. For most children, this period is long enough to halt the secretory process of the middle ear. In others, tubes must be reinserted to continue the aeration. After the procedure, the child has to be careful to not allow water to enter the ears. It is better if the child bathes rather than showers, but showering is all right if ear plugs are used, especially while washing hair. Similarly, swimming is either contraindicated or allowed only with ear plugs in place. Hearing loss is not associated with the use of this procedure.

A toddler is diagnosed with acute otitis media and prescribed antipyretics and numbing ear drops. Which instruction is most important to teach the parents about treatment? importance of administering antibiotics as prescribed option of using heat or cool compresses for comfort option of administering acetaminophen or ibuprofen as needed how to administer the ear drops

how to administer the ear drops Acute otitis media is diagnosed when there is an acute onset of fever and ear pain. The fluid in the middle ear can be infected by either viruses or bacteria. It occurs more often in younger children due to the short length and the horizontal positioning of the Eustachian tube, the limited response to antigens, and the lack of exposure to pathogens. Treatment includes acetaminophen or ibuprofen for pain or fever, warm or cool compresses, and numbing ear drops. When giving instructions about treatment, it is most important for the nurse to teach the parent the correct way to position the pinna to administer the drops. Most parents know how to administer oral medications or apply a cool compress; however, it is rare for parents to know how to pull the pinna to place the ear drops correctly. Depending on the child's age and the severity of the infection, antibiotics may or may not be used.