Nursing Care

of the Child
with Vision
or Hearing
Disorder
Mary Grace Morada Cu, MAN, RN
Clinical Instructor, CNAHS
St. Paul University Manila
 OBJECTIVES
After completing this chapter, the Learners will be able to:

• Describe the structure and function of the eyes and ears and disorders of
these organs as they affect children.
• Assess a child who has a disorder of vision or hearing.
• Formulate nursing diagnoses related to a child with a disorder of vision or
hearing.
• Establish expected outcomes for a child with a disorder of vision or
hearing.
• Plan nursing interventions for a child with a disorder of vision or hearing.
• Implement nursing care to meet the specific needs of a child who has a
disorder of the eyes or ears such as educating parents about the
symptoms of otitis media.
• Evaluate expected outcomes for achievement and effectiveness of care.
• Integrate knowledge of childhood disorders of the eyes or ears with the
nursing process to achieve quality maternal and child health nursing care.

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Child with Vision or
Hearing Disorder

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 HEALTH PROMOTION
AND RISK MANAGEMENT
Hearing Test Visual Screening Tests

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 Hearing Test
Otoacoustic Emissions Automated Auditory
(OAE) Brainstem Response (AABR)

•
measures how the hearing nerve
• measures sound waves produced
and brain respond to sound.
in the inner ear.
• Clicks or tones are played through
• a tiny probe is placed just inside
soft earphones into the baby's
the baby's ear canal.
ears.
• It measures the response (echo)
• 3 electrodes placed on the baby's
when clicks or tones are played
head measure the hearing nerve
into the baby's ears.
MGGMORADACU2020 and brain's response.
 Why Hearing Test

• first and important step in helping understand if the infant may

be deaf or hard of hearing.
• w/o hearing screening, it is hard to know hearing changes in
the first months and years of the baby's life.
• Infants who are deaf or hard of hearing need the right
supports, care, and early intervention services to promote
healthy development.
• if the hearing status is not identified, it may have negative
effects on the baby's communication and language skills.
• Longer term, a missed hearing loss can also impact the
child's academic achievement and social-emotional
development.

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 HEALTH PROMOTION
AND RISK MANAGEMENT
Hearing Test Visual Screening Tests

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 HEALTH PROMOTION
AND RISK MANAGEMENT

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Safety Measures for Preventing
Eye Injuries in Children
Helpful tips to protect children’s vision:
• Place infants and small children in a car seat (for older
children, use a seat belt). Away from hitting the dashboard or
front seat in case of an accident.
• Do not allow infants to hold sharp objects (fist to mouth to
suck his thumb)
• Do not allow toddlers to carry sharp objects such as lollipop
(unsteady gait).
• Do not allow older children to run with sharp objects in their
hands (fall while running and puncture an eye).
• Caution older children to use eye-protection measures, such
as goggles, when working with projects.

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Safety Measures for Preventing
Eye Injuries in Children
Helpful tips to protect children’s vision (cont):
• Encourage the use of face masks for hockey players.
• Teach children not to place any medication in their eyes that
is not prescribed by a health care provider; do not use expired
medication.
• Caution children that chemicals can cause burns to the eye;
alert them to the emergency shower installations in science
rooms that are used to wash away any spilled chemical from
their eyes.
• Teach children not to wear contact lenses for longer intervals
than recommended by the manufacturer, to prevent drying
and lack of oxygen supply to the cornea.

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Safety Measures for Preventing
Hearing Loss in Children
To prevent hearing loss:
• Teach children to avoid chronic exposure to loud noises,
such as can occur with radios and earphones.
• Secure prompt treatment for pharyngitis (fever and sore
throat), because this condition can lead to otitis media
(middle ear infection).
• Caution children not to put anything in their ear canals,
because they could puncture their eardrums.
• Be certain children’s immunizations are up to date,
because illnesses such as parotitis (mumps) or bacterial
meningitis can lead to hearing loss.

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 VISION
• Occurs because light rays reflect from an
object through the corneas, aqueous
humors, lenses, & vitreous humors to
the retinas.
• Retinas are studded with rods and
cones, join in a major network to register
at the optic nerve.
 Rods are for night vision & movement
in the visual field
 Cones, register daylight and color
vision.
• Fovea centralis (the center of the
macula) is an area of closely packed
cones on the retinas where color is best
perceived.

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 VISION
• Single Binocular Vision is a Fusion
occurs in both eyes to interpret a visual
image as one image, fusing visual
perception into a single image.

• Infants with poor eye alignment cannot

establish single binocular vision but
have diplopia, or double vision.

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 VISION- Stereopsis
Stereopsis
• is depth perception, or the ability to locate an object in space relative
to other objects.
• right eye sees more of the right side of an object, whereas the left
eye sees more of the left side. This makes the object appear to be
three dimensional.
• Children with vision loss in one eye do not develop stereopsis and,
tend to reach farther than or closer than the actual distance to an
object when attempting to grasp it.
• Children without stereopsis do not realize that their sight is different
from that of other people.

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VISION- Stereo-Fly
Stereo-Fly or Random Dot
Test
• a simple test for depth
perception
• is a specially constructed
picture of a large fly made of
colored dots.
• HOW: 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.
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 VISION- Accommodation
Accommodation
• is the adjustment the eye makes when
focusing on a close image.
• HOW:
 ask a child to follow a penlight as it
moves in toward the nose.
 Children should be able to do this
by 6 months of age.
 Children who cannot accommodate
have double vision (diplopia), are
unable to focus on objects near
their eyes, and have difficulty
reading.

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 VISION PROBLEMS
• DISORDERS THAT • INFECTION OR • TRAUMATIC INJURY
INTERFERE WITH INFLAMMATION OF TO THE EYE
VISION THE EYE  Foreign Bodies
 Refractive Errors***  Stye***  Contusion Injuries
 Astigmatism  Chalazion  Eyelid Injuries
 Blepharitis marginalis
 Nystagmus  Conjunctivitis*** • INNER EYE
 Amblyopia***  Inclusion blennorrhea CONDITIONS
 Color Vision Deficit  Acute catarrhal  Congenital Glaucoma
(Color Blindness) conjunctivitis
 Herpeticconjunctivitis
• STRUCTURAL  Allergic conjunctivitis
PROBLEMS OF THE  Keratitis
EYE  Periorbital cellulitis
 Dacryostenosis
 Coloboma  Dacryocystitis
 Hypertelorism
 Ptosis
 Strabismus*** MGGMORADACU2020
 DISORDERS THAT
INTERFERE WITH VISION
 Refractive Errors***

 Astigmatism

 Nystagmus-
eyes make repetitive, uncontrolled movements.

 Amblyopia***

 Color Vision Deficit (Color Blindness)

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 Refractive Errors
• The largest category of vision defects in
children is refractive errors. ,
• Light refraction- refers to the manner in
which light is bent as it passes through the
lens. Normally, this bending causes a ray
of light to fall directly on the retina.
• Hyperopia (farsightedness)- the light
rays do not always focus onto the retina
but at a point behind the retina. Vision is
blurry at a close range and clear at a far
range
• Myopia (nearsightedness)- meaning that
the light rays focus at a point in front of the
retina. Vision is blurry at a far range and
clear at a close range
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 Refractive Errors- Hyperopia
• Hyperopia (farsightedness)- vision is
blurry at a close range and clear at a far
range
• the depth of the eye globe in infants and
children increases with age, the light rays
focus at a point behind the retina.
• The normal hyperopia of a preschooler
needs no correction.
• At 5 years of age hyperopia begins to
diminish.
• S/S: children often have headaches or
dizziness after completing schoolwork.
• Mgnt: referral so that the child can get a
prescription for glasses with a convex
lens.
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 Refractive Errors- Myopia
• 10% of school-age children have eye
changes that result in Myopia.
• The light rays focus at a point in front of
the retina.
• Children can read a book or a computer
screen immediately in front of them but
are unable to read the blackboard clearly
in a classroom.
• Often progresses into the teen years,
when it plateaus and remains for life.
• Myopia tends to be familial.

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 Refractive Errors- Myopia
• S/S:
 difficulty reading signs across the street
or playing baseball.
 try to focus on objects by squinting and
rubbing their eyes, which changes the
shape of the eye globe.

NOTE: Any child who reports difficulty seeing

or who shows mannerisms suggestive of
refraction errors—rubbing the eyes, tearing,
red-rimmed eyes, blinking, squinting, or
pressing on the eyes—should be screened
for visual difficulty.

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 Refractive Errors- Myopia
• Therapeutic Management
 Need corrective (concave) lenses to
enable them to see at a distance.
 Past: eyeglasses or contact lenses.
 Present: Laser surgery (Laser in Situ
Keratomileusis LASIK) to permanently
change the contour of the cornea and
correct refractive vision errors by making
an incision under the cornea to change
the contour of the eye globe so that light
rays fall more accurately on the retina.
• PostOp Care:
 artificial tears or ointments to prevent
surface damage.

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Refractive Errors- Myopia
Teaching for Child and Parents
 Encourage child to give glasses a fair try (glasses improve vision
to such an extent that after trying them children will continue to
wear them and may need continued encouragement to keep
wearing glasses until they are old enough for contact lenses or
surgical correction).
 If parents are going to purchase eyeglasses, advise them to
choose frames fitted with plastic or safety glass (shatterproof)
lenses to prevent injury.
 Children as young as 5 years of age are capable of putting in
contact lenses and taking them out if taught properly.
 Educate them that contact lenses require conscientious cleaning
or changing to prevent eye irritation or infection.
 Children are usually about 12 years of age before they can be
relied on to take appropriate care of contact lenses totally
independently.

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Amblyopia (Lazy Eye)
• “lazy eye,” or subnormal vision in one eye;
• child may be using only one eye for vision
while “resting” the other eye.
• If process continues too long, central
vision fails to develop (or the central vision
that had developed fades), and the child
becomes functionally blind in one eye.
• occur in children who have a refractive
error in one eye that is significantly
different from that of the other eye or in
children with astigmatism.

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 Amblyopia (Lazy Eye)
• Can also develop from Strabismus
(crossed eyes), one eye looks straight
ahead while the other eye “wanders.”
• Children who have an eye that wanders
are constantly looking at two separate
images rather than one fused image.

• The same phenomenon occurs if the

vision in one eye is obscured by a lid that
does not open fully called Ptosis
(drooping eyelid).

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 Amblyopia (Lazy Eye)
• Assessment
 All preschool children should be
screened for amblyopia by vision
testing with a preschool E chart at
routine health visits.
 A child with amblyopia has 20/50 vision
(normal for preschool age) in one eye,
and the other eye shows lessened
vision (perhaps 20/100).

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 Amblyopia (Lazy Eye)
• Therapeutic Management
 correctable if treated during the preschool
period (prognosis for correction is considerably
diminished after 6 years of age).
 good eye is covered by a patch held firmly in
place which forces the child to use the poor
eye, thus developing vision in that eye. -may
develop headaches or dizziness and notice
poor depth perception
 patch is removed for 1 hour each day to
prevent amblyopia from developing in the
nonamblyopic eye.
 Levodopa, occlusion therapy as this almost
immediately improves vision in the poorer eye.
 Atropine, causes pupil dilation and blurred
vision when dropped into the better eye, may
be yet another solution.

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 Amblyopia (Lazy Eye)
• Nsg Diagnosis
 Deficient knowledge deficit r/t to need for
consistent wearing of patch
 Disturbed Visual sensory perception r/t visual
distortion (unable to see well from the
unpatched eye)
 Risk for Fall
 Risk for Injury

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 STRUCTURAL
PROBLEMS OF THE EYE

 Coloboma

 Hypertelorism

 Ptosis

 Strabismus***

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 Strabismus (Cross-Eyes)
• is unequally aligned eyes (cross-eyes) caused by
unbalanced muscle control.
• the condition occurs without regard to gender,
social status, or geographic area.
• 30% of children with strabismus have a history in
the family.
• the resting position of one eye may be divergent
(turned out) or convergent (turned in).
• one pupil may be higher than the other (vertical
strabismus).
• may be monocular, (same eye deviates
constantly), or it may be an alternating strabismus
(one eye and then the other deviates).
• both the resting position of eyes and the amount
of turning necessary to read small print depend on
the eyes’ ability to fuse and see only one image.

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 Strabismus (Cross-Eyes)
• TYPES OF HORIZONTAL STRABISMUS
 Esotropia is inward turning of the eyes (crossed
eyes).

 Exotropia is the term used to describe outward

turning of the eyes (wall-eyed)

• TYPES OF VERTICAL STRABISMUS?

 Hypertropia is an abnormal eye higher than the
normal eye.

 Hypotropia is when the abnormal eye is lower

than the normal eye.

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 Strabismus (Cross-Eyes)
• Assessment
 Infants’ eyes may cross occasionally until 6
weeks of age, after 6 weeks should be referred
for diagnosis and treatment (constant
strabismus before 6 weeks of age need referral
right away).
 definite deviations are obvious (exotropia,
esotropia ,hypertropia, hypotropia.
 be most striking when child is tired or sick
 detected best when children examine a nearby
object.
 may experience headaches; tired, irritated eyes;
and perhaps even nausea and vomiting.

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 Strabismus (Cross-Eyes)
• Assessment (cont)
 Pseudostrabismus- Children who have flat,
broad-bridged noses, a narrow interpupillary
distance, and an epicanthal fold or ovalshaped
palpebral fissures may appear to have
strabismus when they truly do not.

 Pseudoesotropia- children have less white

sclera visible in the inner margin of the eye
than normally, so the eye appears to be turned
in,

• A cover test reveals the true condition.

• Hirshberg’s test is another method of detecting
true strabismus

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 Strabismus (Cross-Eyes)
MAJOR TYPES OF STRABISMUS
• Concomitant (nonparalytic) Strabismus
 most usual type found in children.
 all the muscles of the eye are capable but they are not functioning together.
 the deviation is equally apparent in all directions of gaze.
• Paralytic Strabismus
 caused by paralysis of a muscle or nerve, an injury (birth injury or invading
lesion).
 eyes appear straight except when they are moved in the direction of the
paralyzed muscle.
 double vision occurs, and the crossed eye is evident.
 children often close one eye or tilt their head to decrease the double vision.
 may tilt their head so much they appear to have a torticollis, or “wry neck” an
orthopedic rather than an eye problem.
 often fussy or clumsy because of the diplopia or fussy because they cannot
see well and too young to describe what is happening to them
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 Strabismus (Cross-Eyes)
• Assessment (cont)
 Pseudostrabismus- Children who have flat,
broad-bridged noses, a narrow interpupillary
distance, and an epicanthal fold or ovalshaped
palpebral fissures may appear to have
strabismus when they truly do not.

 Pseudoesotropia- children have less white

sclera visible in the inner margin of the eye
than normally, so the eye appears to be turned
in,

• A cover test reveals the true condition.

• Hirshberg’s test is another method of detecting
true strabismus

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 Strabismus (Cross-Eyes)
Therapeutic Management
 The therapy for strabismus depends on the cause
of the problem.
 If the fusion mechanism is weak, eye exercises
(orthoptics) may be necessary.
 If eyes are diverging with attempted convergence
because of farsightedness or nearsightedness,
the child needs glasses to correct the basic visual
defect.
 If the misalignment is caused by unequal muscle
strength, eyemuscle surgery to correct the
problem, although injection of botulinum toxin into
the eye muscle may be tried first as temporary
therapy or as an adjunct to surgery (This
paralyzes the muscle, temporarily aligning vision)
 need to prevent diplopia.
 eye correction must be done early in life, before 6
years of age.
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 Strabismus (Cross-Eyes)
• Post-Op Care
 eye patches are not required.
 antibiotic ointment is applied to the eye for 2 or
3 days.
 decrease pain

• Follow-up visits after surgery are necessary to

determine the success of the surgery.
• Retest children who have had this surgery
periodically at health maintenance visits to be
certain that their vision remains equal and eye
alignment remains straight.

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 INFECTION OR
INFLAMMATION OF THE
EYE
 Stye***  Conjunctivitis***

 Chalazion  Acute catarrhal conjunctivitis

 Herpetic conjunctivitis
 Allergic conjunctivitis
 Blepharitis marginalis

 Periorbital cellulitis
 Inclusion blennorrhea

 Dacryostenosis
 Keratitis  Dacryocystitis

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 Stye
• infection of a ciliary gland (a modified sweat
gland) that enters into the hair follicle at the lid
margin
• is a red, painful bump that forms either on or
inside the eyelid near the edge of the eyelashes
• most commonly caused by Staphylococcus.

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 Stye
• S/S:
 Painful red bump along the edge of the upper
or lower eyelid near the base of the
eyelashes
 Swelling of the eyelid (sometimes the entire
eyelid)
 Crusting along the eyelid
 Sensitivity to bright light
 Sore, scratchy eye
 Tearing of the eye
 A feeling that there is something in the eye

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 Stye
• Therapeutic Management:
 Apply a warm washcloth to the eyelid. Apply
for 10 to 15 minutes at a time, 3 to 5 times a
day. Rewarm washcloth as needed by
soaking it in warm water. Wring out excess
water, then reapply to the eyelid.
 Gently wipe away eyelid drainage with mild
soap and water, or eyelid wipes
 Incision (under local anesthesia) to drain the
sty
 Antibiotic ointment to apply to the eyelid or
antibiotic eye drops. Sometimes antibiotic
pills are prescribed if there is infection of the
area surrounding the eye or after incision
and drainage of an internal sty.
 Steroid injection into the sty to reduce the
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 Conjunctivitis (Pink Eye)
• is an inflammation or infection of the transparent
membrane (conjunctiva) that lines your eyelid and
covers the white part of your eyeball.
• small blood vessels in the conjunctiva become
inflamed, it become more visible and appear
reddish or pink.
• Causes: bacterial (most serious—ophthalmia
neonatorum [exposure to gonococcus bacillus];
Viral or Fungi

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 Conjunctivitis (Pink Eye)
S/S:
• Redness in one or both eyes
• Itchiness in one or both eyes
• A gritty feeling in one or both eyes
• A discharge in one or both eyes that forms a crust
during the night that may prevent your eye or eyes
from opening in the morning
• Tearing

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 Conjunctivitis (Pink Eye)
• Diagnosis:
 Patient history
 Visual acuity measurements to determine
whether vision has been affected.
 Evaluation of the conjunctiva and external
eye tissue using bright light and magnification.
 Evaluation of the inner structures of the
eye to ensure that no other tissues are affected
by the condition.
 Supplemental testing, which may include
taking cultures or smears of conjunctival tissue.

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 Conjunctivitis (Pink Eye)
• Therapeutic Management:
 Cool, moist compresses to affected eye
 Application of an antibiotic ointment
 Follow-up visit mandatory to be certain
infection clears

• Three main goals:

 Increase patient comfort.
 Reduce or lessen the course of the infection or
inflammation.
 Prevent the spread of the infection in
contagious forms of conjunctivitis.

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 Conjunctivitis (Pink Eye)
• Prevention:
Practice good hygiene to control the spread of
pink eye. For instance:
 Don't touch your eyes with your hands.
 Wash your hands often.
 Use a clean towel and washcloth daily.
 Don't share towels or washcloths.
 Change your pillowcases often.
 Throw away your eye cosmetics, such as
mascara.
 Don't share eye cosmetics or personal eye
care items.

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 EAR

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 Physiology of Hearing Loss
• Hearing loss = “conduction loss”
• there is interference with sound reaching the inner ear
• Nerve or Sensorineural loss if the inner ear or the
eighth cranial nerve is affected.
• Conduction loss can occur:
 in external canal is obstructed with cerumen (wax)
or a foreign object,
 in tympanic membrane is damaged or immobile, or
if the middle ear is filled with fluid, as occurs in
serous otitis media.
• Sensorineural loss results from
 diseases that affect the transmission of sound
sensation to the cerebral cortex or from a pathologic
condition of the cochlea.
 can occur after drug therapy or an infection such as
meningitis.
 can occur from exposure to loud sound MGGMORADACU2020
 Hearing Impairment
• occurs in many different degrees and is rated by level
of severity.
• with Usual classifications (will be showed next slide).
• Approximately 1 in 1000 children in the United States
are profoundly hearing challenged; 17 in 1000 children
have a moderate to severe hearing impairment.
• Congenital sensorineural hearing loss occurs in 2 to 3
of every 1000 live births according to National Institute
on Deafness and Other Communication Disorders.
• Prenatal rubella infection accounts for another large
percentage.
• Causes of slight hearing impairment include serous
otitis media, trauma from such things as inflating
airbags, and untreated acute otitis media with rupture of
the tympanic membrane.

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MGGMORADACU2020
 Hearing Impairment
• occurs in many different degrees and is rated by level
of severity.
• with Usual classifications (will be showed next slide).
• Approximately 1 in 1000 children in the United States
are profoundly hearing challenged; 17 in 1000 children
have a moderate to severe hearing impairment.
• Congenital sensorineural hearing loss occurs in 2 to 3
of every 1000 live births according to National Institute
on Deafness and Other Communication Disorders.
• Prenatal rubella infection accounts for another large
percentage.
• Causes of slight hearing impairment include serous
otitis media, trauma from such things as inflating
airbags, and untreated acute otitis media with rupture of
the tympanic membrane.

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 DISORDERS OF THE EAR
• External Otitis***

• Impacted Cerumen

• Acute Otitis Media***

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 External Otitis
• aka Otitis Externa (Swimmer’s Ear).
• is inflammation of the external ear canal.
• can cause discomfort in the form of itching and
sometimes extreme pain.
• Causes:
 bacterial infection (most cases)
 irritation
 fungal infections
 allergies

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 External Otitis
• Assessment:
 History of children reveals recently swimming
(swimmer’s ear).
 The moisture in the canal (from swimming) caused
inflammation; a secondary infection then occurs in
the closed space (Pseudomonas and Candida)
 Otoscopic examination may indicate only the
sharply localized, tender swelling of a furuncle, or
the entire canal may be swollen shut and tender to
the touch.
 If a fungal infection, the entire canal may appear
brown or black.
 If the inflammation is from a foreign body, such as a
tip of a cotton applicator, white or gray debris may
surround the object; the skin under the object will
be moist, red, and eroded.

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 External Otitis
• Diagnostic:
 Tympanic membrane must be visualized to
ensure that there is no extension of the external
otitis into the middle ear (Before visualization:
remove superficial debris from the canal).
 A Weber test: vibration that sounds louder in the
affected ear suggests that otitis media (middle
ear infection) is present.
 Otoscopic examination may indicate only the
sharply localized, tender swelling of a furuncle,
or the entire canal may be swollen shut and
tender to the touch.

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 External Otitis
Therapeutic Management:
• treatment differs according to the organism causing the
infection.
• if the canal is so swollen, a cotton wick moistened with
Burow’s solution may be threaded into the canal.
• the cotton extending out into the auricle is kept
moistened by rewetting it for 24 hours with Burow’s
solution.
• ear drops containing hydrocortisone and an antibiotic or
an antifungal mixture.

x
 Hydrocortisone reduces inflammation;
 Antibiotic or Antifungal preparation reduces the
infection.
 Analgesics for ear pain such as acetaminophen or
ibuprofen
• Children must keep the ear canal dry by avoiding
swimming and hair washing during this time.
• For shower, first insert ear plugs into the external
meatus, to keep out moisture.
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 Acute Otitis Media
• inflammation of the middle ear (otitis media) is the most prevalent disease of
childhood after respiratory tract infections.
• occurs most often in children 6 to 36 months of age and again at 4 to 6 years.
• higher incidence in formula-fed infants because they are held in a more slanted
position while feeding, and this allows milk to enter the eustachian tube.
• also associated with constant pacifier use.
• highest in the winter and spring and is higher in homes in which a parent smokes
cigarettes
• an extremely serious disease of childhood, because permanent damage can
occur to middle ear structures, leading to hearing impairment.

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Acute Otitis Media
• Assessment:
 occurs after a respiratory tract infection.
 a “cold,” rhinitis, and perhaps a lowgrade fever for
several days suddenly becomes 38° C and a sharp,
constant pain in one or both ears.
 older children verbalize pain.
 infants become extremely irritable and frequently pull or
tug at the affected ear to gain relief from pain.
 external canal is usually free of wax (the warmth of the
inflammation & fever melts the wax & moves it more
readily out of the canal).
 tympanic membrane appears inflamed or reddened on
otoscopic examination (bulging into the external canal).
 decreased mobility on pneumatic examination with
otoscope.

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Acute Otitis Media
Tympanocentesis

• (withdrawal of fluid from the middle ear

through the tympanic membrane) may be
performed by a physician to obtain fluid
for culture at the time of assessment.
• a minor surgical procedure that refers to
puncture of the tympanic membrane with
a small gauge needle in order to aspirate
fluid from the middle ear cleft or to
provide a route for administration of
intratympanic medications

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 Acute Otitis Media
Therapeutic Management:
• antibiotic therapy is unnecessary and may add to
bacterial resistance, so it is no longer routinely
prescribed (resolve spontaneously without therapy)
• chronic or persistent otitis media may be caused by
Staphylococcus, which would require treatment with an
antibiotic, such as a cephalosporin, that is effective
against Staphylococcus.
• analgesic and antipyretic
• decongestant nose drops to open the eustachian tubes
and allow air to be admitted to the middle ear x3days
• conductive hearing loss (may last up to 6 months),
Caution parents about this.
• If a child still has a conductive hearing loss after 6
months (or has other symptoms), the child should be
examined again to see whether a new infection or
serous otitis media is present
MGGMORADACU2020
Nursing Care
of the Child
with Vision
or Hearing
Disorder
Mary Grace Morada Cu, MAN, RN
Clinical Instructor, CNAHS
St. Paul University Manila