1229 Exam 6: Otitis Media Flashcards
4 Different sets of Tonsils
Pharyngeal Tonsil
Tubal Tonsil
Palatine Tonsil
Lingual Tonsil
Functions of Tonsils
filter pathogens, antibody formation, they are larger in children for protection, smaller in adolescence and adult
Tonsillectomy
is the removal of the palatine tonsils
Tonsillectomy and Adenoidectomy
the removal of tonsils and adenoids
Tonsillitis
inflammation of the tonsils
Causes of Tonsillitis
Can be bacterial or viral
Bacterial-swollen uvula, whitish spots, red swollen tonsils, throat redness, gray furry tongue
Viral-red swollen tonsils, throat redness
Pharyngitis
gradual onset, low-grade fever, rhinitis, cough, hoarseness occur after 1-2 days of fever, erythema of pharynx, tonsil enlargement, firm tender cervical lymph, Moderately ill 1-5 days Viral
Bacterial Pharyngitis (Tonsillitis, Streptococcal (GABHS) )
Abrupt onset, fever 104, acute onset, severe sore throat, abd pain, white exudate pharynx and tonsils, erythema, tonsil enlargement, tender cervical lymph nodes, acutely ill up to 2 weeks
Nur Considerations in Tonsillitis
comfort, soft liq diet, cool mist humidifier, warm salt water to gargle, throat lozenges, analgesic and antipyretic
Surgical
Indications-massive hypertrophy, inflammation, malignancy, airway obstruction
Adenoidectomy- follow up with hearing, speech and taste
Contraindications-cleft palate, acute inflammation, blood dyscrasias, after age 4
Prior to Surgery
History, Lab work, V/S, symptoms of URI, loose teeth, pysch support
Post Op
side lying, careful suctioning, prevent bleeding(no coughing, clearing throat or blowing nose), inspect vomit, throat sore, ice collar, pain med, offer liquid or soft foods, watch for post op hemorrhage
Discharge Teaching
Fluid Replacement, foods soft and non spicy, watch for hemorrhage, tachycardia, pallor, frequent throat clearing or swallowing, vomiting bright red blood, limit activities, pain control
Notify MD if severe earache, fever or cough,
Can hemorrhage up to 10 days post op
Otitis Media
middle ear infection
age:6mo - 2 yr, preschool boys, large households, smoker, day care, bottle fed
Causes of Otitis Media
Viral: RSV and Flu
Bacterial: strep, influenza, morzxella
Non infections OM from blockage
Patho
swelling and blocking of eustachian tube, dysfunctioning eustachian tube
ET tube functions
protection, drainage, and ventilation
Acute OM s/s
irritable, pull ears, roll head side to side, high temp 104, bulging red tympanic membrane, rhinorrhea, vomiting, diarrhea, loss of appetite, rupture of tympanic membranes
Nur considerations of OM
analgesics, antipyretics, topical pain relief drops, external application of heat or cold
Meds for OM
antibiotics- amoxicillin, azithromycin, cephalosporins, IM ceftriaxone
Definition OM w/ Effusion
fluid in the inner ear space with s/s of infection
Causes of OM w/ Effusion
inflamed and enlarged adenoids, blockage of ET tube
Complications of OM w/ Effusion
hearing loss, pain, and ruptured tympanic membrane
S/S of OM w/ Effusion
exudate, pressure, possible tympanic membrane rupture, fullness in ear, popping when swallow, feeling of motion in ear, fluid in persist in middle ear for weeks to months, will have some hearing impairment
Goal Therapy of OM w/ Effusion
establish/maintain aerated middle ear free of fluid and achieve normal hearing
Why tubes?
a small incision is made in the tympanic membrane, tube inserted drains fluid, an ear infection with fluid behind tympanic membrane
Otitis Externa
inflammation of the external ear and infection in ear canal, ear pain, best management is to prevent dirt or objects into ear canal, teach to put nothing smaller than elbow in ear canal
