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

The nurse is caring for a preschool-aged child diagnosed with acute otitis media. Which intervention should be a priority for the nurse?

Relieving pain

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?

"20/20 vision isn't usually achieved until the age of 6 or 7 years but I will let the physician know your concerns."

A child diagnosed with acute otitis media has been given a prescription for benzocaine. The nurse is correct when she makes which statement?

"Benzocaine drops should be placed in your ear to numb it and reduce pain."

A 13-year-old reports she recently saw a television program showing surgery to correct vision problems. She states she hates wearing glasses and wants to have this procedure done. What is the best response by the nurse?

"Although there are surgeries for vision, they are not normally recommended for someone your age."

The nurse has finished teaching the parents of a 10-month-old male ways to prevent another acute otitis media infection. Which statement by the mother indicates she has the correct understanding of the information provided?

"I should continue to breastfeed my son because it lowers the incidence of acute otitis media."

The nurse has finished teaching the mother of a 5-year-old male diagnosed with bacterial conjunctivitis how to manage her son's infection at home. Which statement by the mother would indicate a need for further education?

"I will use Visine drops in his infected eye to help reduce redness."

The caregiver of a 2-year-old calls the clinic concerned that her child may have pushed paper into her ears, and she asks the nurse what to do. The mother found the child pushing on her ears with torn paper on the floor in front of her. What would be the appropriate response by the nurse?

"The child should be seen by a care provider. Don't put anything in her ear and bring her in right away."

A child having myringotomy tubes placed asks, "How and when will the tubes be removed?" What is your best response?

"The tubes remain in place for 6 to 12 months until they come out by themselves."

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."

The nurse has recently admitted a blind child to the pediatric unit. Which interventions should the nurse implement? Select all that apply.

- Identify herself to let child know she is there before touching the child. - Allow the child additional time to think about a response to a question. - Explain what individuals are doing.

An infant born with congenital glaucoma is scheduled for surgery. Which preoperative order should the nurse question for this patient?

A preoperative injection of atropine

The nurse is caring for a 20-month-old girl with equivocal bacterial otitis media, a severe earache, and a temperature of 39°C (102.2°F). Which intervention would the nurse expect to implement?

Administering antibiotics as soon as they're available

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.

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 the child's ability to convey information.

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

The school nurse is assessing a student complaining of left eye pain. Upon visual inspection, the nurse notes left conjunctivae redness and thick, colored discharge. The nurse understands that these signs and symptoms are consistent with which diagnosis?

Bacterial conjunctivitis

If the child is following a normal development process, visual acuity gradually increases from birth. What is most accurate regarding the age children develop 20/20 vision?

Children usually develop 20/20 vision by 5 years of age.

The nurse is caring for a 10-year-old child with bacterial conjunctivitis of the right eye. The eye is inflamed and drains a thick, yellow discharge. What should the nurse teach the patient about the care of the eye?

Clean the discharge away from the inner to outer canthus.

The nurse is providing immediate postoperative care for a 3-month-old who had a cataract removed. Which intervention would be the priority?

Ensuring the protective eye patch is securely in place

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

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 to understand?

Student placement in the room is important but all other teaching methods may remain the same.

A mother asks the nurse if there is any way to prevent acute otitis media. What would the nurse state to the mother?

The frequency of otitis media is reduced in breast-fed infants.

The nurse is educating the parents of a 5-year-old girl with infectious conjunctivitis about the disorder. Which information is most important to provide to prevent the spread of the disorder?

Washing hands frequently

The most effective approach to prepare a school-aged boy for a myringotomy procedure is to

explain the procedure to the child using puppets.

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.

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?

Instill a few drops of a topical anesthetic into the affected eye

The health care provider orders amoxicillin 35 mg/kg/day in three divided doses for a child with otitis media. The child weighs 44 lb and the medication is available in a suspension of 50 mg/mL. What is the total daily dosage in mL for this child?

14 mL

The nurse is planning care for a school-age child with a black eye. Which outcome would be the most appropriate for this patient?

Evidence of bleeding will be reabsorbed within 1 to 3 weeks.

The nurse is assessing a 5-month-old infant. What would cause the nurse to be concerned about a possible visual impairment?

The infant does not imitate facial expressions.

The nurse is taking a health history for a 9-year-old with conjunctivitis. Which finding would suggest that this is allergic conjunctivitis?

Recently helped clean the basement

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."

The mother of a child having myringotomy tubes placed asks, "Will my son lose his hearing while the tubes are in place?" What is the nurse's best answer?

"The tubes are inserted into a section of eardrum in which the hearing is not affected."

In children with otitis media, a procedure known as a myringotomy may be performed. Which statement is most accurate regarding this procedure?

During this procedure, small tubes are inserted into the typmpanic membrane.

The nurse is teaching the family of a 6-year-old boy with allergic conjunctivitis how to minimize his exposure to allergens. What action would the nurse anticipate as being most difficult for the family to implement?

Encouraging the child to keep his hands away from his eyes.

A child returns to the clinic after an episode of otitis externa, which has resolved. What would the nurse emphasize as the priority for preventing future episodes?

Keeping ear canals dry,

The outpatient care clinic receives the 2020 National Health Goals that focus on prevention, early detection, treatment, and rehabilitation of vision problems. What should the nurse remind each patient to do to ensure eye health?

Use personal protective eyewear during recreation and hazardous situations.

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?

"Children's vision is not completely developed by this age. Your child might outgrow this nearsightedness."

The nurse is caring for an 8-year-old hospitalized child who is visually impaired. Which nursing intervention would be the highest priority in helping this child reduce anxiety related to hospitalization?

The nurse talks to the child when entering and leaving the room.

A 5-year-old develops an otitis media with effusion. Myringotomy tube insertion is scheduled. The mother asks, "Why does this have to be done at the hospital?" What would be your best response?

"He will need to lie still afterward, so he will need to remain at the hospital for a short time."

Hearing aids can improve hearing for children who have inner ear or nerve deafness.

False