NURSING MANAGEMENT

 Determine pain characteristics through client’s description

 Use pain rating scale appropriate for age
 Monitor skin color and vital signs
 Encourage to increase fluid intake to decrease susceptibility to infection
 Reduce noise in the client environment.
 Look at the client when speaking.
 Speak clearly and firmly on the client without the need to shout.
 Provide good lighting when the client relies on the lips.
 Use the signs of non-verbal (eg facial expressions, pointing, or body movement) and other
communications.
 Encourage to listen to music, have focused breathing, socializing to others or other diversional
activities
 Administer analgesics as ordered by the physician
 Have the child sit up, raise head on pillows, or lie on unaffected ear. Elevation decreases
pressure from fluid.
 Apply heating pad or warm hot water bottle. Heat increases blood supply and reduces
discomfort.
 Have the child/patient chew gum or blow on balloon to relieve pressure in ear. Attempts to
open the eustachian tube may help aerate the middle ear.
 Instruct family or the people closest to the client on how techniques of effective communication
so that they can interact with clients to distract attention and reduce tension towards pain
 If the client wants, the client can use hearing aids.
 Assess motor and language development at each health care visit. Early detection of
developmental delays can lead to appropriate intervention

http://nursingfile.com/nursing-care-plan/nursing-interventions/nursing-interventions-for-acute-otitis-
media.html

SURGICAL MANAGEMENT
Tympanocentesis

Tympanocentesis is a diagnostic and therapeutic procedure in which a needle is inserted through

the tympanic membrane to aspirate fluid from the middle ear space.

 The procedure is considered diagnostic when the material obtained is sent for laboratory
and/or microbiological analysis.
 It is considered therapeutic in most instances because it relieves pressure, thereby
reducing pain and many times shortens the course of an acute otitis media (AOM).

https://accessemergencymedicine.mhmedical.com/content.aspx?
sectionid=45343815&bookid=683

Myringotomy
Myringotomy is a surgical procedure of the eardrum or tympanic membrane. The procedure
is performed by making a small incision with a myringotomy knife through the layers of
tympanic membrane so fluids such as water, blood, or pus can drain out. This surgical
procedure permits direct access to the middle ear space and allows the release of middle-
ear fluid to reduce pain, improve hearing and reduce infections.

https://www.webmd.com/cold-and-
flu/ear-infection/qa/what-is-a-myringotomy

https://emedicine.medscape.com/article/1890977-overview