Peds- eye/ear

A 1-year-old child is seen in the health care provider's office with complaints of an elevated temperature that began the previous evening. When gathering subjective data from the mother, the nurse notices that which sign/symptom would most likely indicate the child has acute otitis media?

4. The mother states the child had purulent discharge from the ear last night.

The nurse is reinforcing discharge instructions to the mother of a child who had a myringotomy with insertion of tympanostomy tubes. The nurse instructs the mother that if the tubes fall out, she should take which action?

2. Contact the health care provider.

The nurse receives a call from the mother whose child has a foreign body in the eye. The object is clearly visible and not embedded. When the mother asks for the most effective way to get it out, the nurse should give which response?

4. Touch the object gently with a cotton swab, and lift it out.

The nurse has provided instructions to the mother of a child who has been diagnosed with bacterial conjunctivitis. Which statement by the mother would indicate the need for further teaching?

3. "It is okay to share towels and washcloths."

The mother of a child who had a myringotomy with insertion of tympanostomy tubes calls the nurse and tells the nurse that the "tubes" fell out. The nurse should make which response to the mother?

3. "This is not an emergency. I will speak to the health care provider and call you right back."

A 4-year-old child is diagnosed with otitis media, and the mother asks the nurse about the causes of this illness. The nurse responds, knowing that which is an unassociated risk factor related to otitis media?

3. A history of urinary tract infections

The nurse reinforces discharge instructions to the mother of a child following a myringotomy with insertion of tympanostomy tubes. Which statement by the mother indicates a need for further teaching?

4. "I need to be sure my child uses soft tissues to blow his nose."

The nurse assists to prepare a teaching plan regarding the administration of eardrops for the parents of a 2-year-old child. Which should be included in the plan?

3. Pull the earlobe down and back before instilling the eardrops.

The nurse is reinforcing home care instructions to the mother of a child with bacterial conjunctivitis. Which instruction should the nurse give the mother?

3. That the child's towels and washcloths should not be used by other members of the household

The day care nurse is observing a 2-year-old child and suspects that the child may have strabismus. Which observation may be indicative of this condition?

3. The child consistently tilts his or her head to see.

The nurse is attempting to ensure the parent is able to safely administer at home the prescribed ear drops to the 2-year-old client. The parent demonstrates understanding of the teaching by listing the steps of the process in which priority order? Arrange the actions in the order that they should be performed. All options must be used.

Warm the bottle of ear drops by rolling it in the palms of the hands to help decrease discomfort. Have the child lie on his or her back with the affected ear facing up. Straighten the ear canal by pulling the pinna of the affected ear down and back. Slowly instill the number of drops prescribed by the health care provider into the ear. Massage the area anterior to the ear to facilitate entry of the drops. Keep the child in the same position for 2 to 3 minutes.

A 10-month-old child presents to the clinic with irritability, rubbing and pulling at the right ear, and a temperature of 102.4° F. The health care provider diagnoses the child with acute otitis media (OM) of the right ear, prescribes broad-spectrum antibiotics, and provides instructions to the parent, who verbalizes an understanding of the treatment plan. The parent later asks the nurse how to prevent future episodes of OM. Which instructions should the nurse reinforce in parent teaching? Select all that apply.

1,3,5

The nurse reinforces instructions to parents regarding the methods that will decrease the risk of recurrent otitis media in infants. Which should the nurse include in the instructions?

1. "Feed the infant in an upright position."

A health care provider has told the mother of a newborn diagnosed with strabismus that surgery will be necessary to realign the weakened eye muscles. The mother asks the nurse when the surgery might be performed. Which time frame for the surgery should the nurse explain to the mother?

2. Before the child is 3 years old

A health care provider prescribes "eye patching" for a child with strabismus of the right eye. The nurse reinforces instructions to the mother to use which procedure for eye patching?

2. Place the patch on the left eye.

A mother of a child who underwent a myringotomy with insertion of tympanostomy tubes calls the nurse and reports that the child is complaining of discomfort. Which should the nurse instruct the mother to do?

3. Give the child acetaminophen (Tylenol) for the discomfort as per discharge instructions.

The mother of a child arrives at the clinic because the child has been experiencing scratchy, red, and swollen eyes. The nurse notes a discharge from the eyes and a culture is sent to the laboratory for analysis. Chlamydial conjunctivitis is diagnosed. Based on this diagnosis, which should require further investigation?

2. Possible sexual abuse

The nurse is assigned to care for a child after a myringotomy with the insertion of tympanostomy tubes. The nurse notes a small amount of reddish drainage from the child's ear after the surgery. On the basis of this finding, which action should the nurse take?

1. Document the findings.

A 9-year-old child is diagnosed with chlamydial conjunctivitis. The nurse consults with the health care provider regarding necessary follow-up because this infection can be associated with which finding?

1. Possible sexual abuse

Antibiotics are prescribed for a child following a myringotomy with insertion of tympanostomy tubes, and the nurse provides instructions to the parents regarding the administration of the antibiotics. Which statement made by a parent would indicate that the instructions were understood?

1. "We will administer the antibiotics until they are gone."