NCLEX-PN Exam Prep, 2/e (PATRICIA BLAIR's Library)

Author:Wilda Rinehart & Diann Sloan & Clara Hurd
Language: eng
Format: epub
Publisher: Pearson IT Certification
Published: 2011-06-12T16:00:00+00:00

Acute Otitis Media

Acute otitis media (AOM) is one of the most common respiratory diseases in childhood. The incidence is highest in children 6 months to 3 years of age. Otitis media is more prevalent in the young child because the eustachian tube is straighter, shorter, and wider than in older children or adults. The shorter eustachian tube allows bacteria and viruses to find their way into the middle ear more easily. Normal adenoidal enlargement in children can interfere with opening of the eustachian tubes and increase the incidence of infection. Other factors that contribute to AOM in infants and young children are immaturity of the immune system, passive smoking, attendance at day care, and supine positioning with bottle feeding. In AOM, the child develops a high fever (103°–104°F), anorexia, vomiting, and pain. Assessment of the tympanic membrane reveals redness and bulging of the eardrum due to the presence of fluid in the middle ear. The infant or young child might be seen rubbing or pulling at the affected ear or rolling her head from side to side. Increasing pressure can rupture the eardrum. If rupture occurs, pain and fever subside and purulent fluid may be noted in the ear canal.

The organism responsible for AOM is usually H. influenza, although other organisms (such as S. pneumoniae and M. catarrhalis) can also produce an acute infection. Treatment of AOM involves the use of antibiotics, including oral amoxicillin, sulfonamides, erythromycin, or cephalosporins. Antipyretics such as ibuprofen or acetaminophen can be given to reduce fever and pain.

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