ACTIVITY DAY 2

I. ANSWER THESE QUESTIONS ON YOUR UNDERSTANDING ACCORDING TO   

   WHAT YOU HAD READ/ NOR RESEARCHED.

1. If ear infection is untreated, mention at least 2 complications and discuss.

 Hearing loss, which could result if infections occur frequently or never fully heal. Most of the
time, hearing loss is only temporary, and the risk of permanent hearing loss due to ear infections
is low, affecting about 2 out of every 10,000 children who suffer from a middle ear infection. If
hearing loss does occur, however, it can be troublesome, especially for young children who are
just learning to speak. “The way they learn, speech and language education is by hearing and
overhearing,” Chandrasekhar says. It becomes an even more serious concern if the infection
affects both ears instead of just one. Prolonged hearing loss among young children could lead to
delays in a child learning to talk and understand adults.
 Meningitis, which is an infection in the membranes surrounding the brain and spinal cord.
(Adults and children over age 2 may exhibit flu-like symptoms, including headaches, fever, and
nausea, while infants may cry constantly, seem extremely tired, or experience stiffness in their
body and neck. Chandrasekhar says if bending your neck forward to touch your chin to your
chest really hurts, it could be a sign of meningitis. Meningitis can be life-threatening or can lead
to permanent brain damage, so it’s important to see a doctor as soon as you have these signs
and symptoms. The usual treatment is hospitalization and antibiotics through an IV for up to 21
days.

2. Why is ringing of the ear present in ear infection? discuss

 our ear canals can become blocked with a buildup of fluid (ear infection), earwax, dirt or other
foreign materials. A blockage can change the pressure in your ear, causing tinnitus
 Infections of the outer and middle ear can both cause Tinnitus. Ear infections will often involve
swelling or fluid that can cause enough of a blockage to damage the eardrum and bring on that
annoying ringing (or buzzing or hissing). Tinnitus can improve by identifying and treating the
underlying condition.

3. Mention at least 2 diagnostic procedures and discuss.

 Pneumatic otoscope
An instrument called a pneumatic otoscope is often the only specialized tool a doctor needs to diagnose
an ear infection. This instrument enables the doctor to look in the ear and judge whether there is fluid
behind the eardrum. With the pneumatic otoscope, the doctor gently puffs air against the eardrum.
Normally, this puff of air would cause the eardrum to move. If the middle ear is filled with fluid, your
doctor will observe little to no movement of the eardrum.

 Tympanometry.
This test measures the movement of the eardrum. The device, which seals off the ear canal, adjusts air
pressure in the canal, which causes the eardrum to move. The device measures how well the eardrum
moves and provides an indirect measure of pressure within the middle ear.

4. Is acute otitis media treated with Medical and Surgical? Discuss

Yes! AOM can be treated medical and surgical below are some example of treatment that can be done.
 Surgery. Maintaining middle ear ventilation to reduce the severity and frequency of OM and to
maintain the development of hearing, speech, and balance remains the focus of surgical
management of otitis media.

 Management of acute otitis media should begin with adequate analgesia. Antibiotic therapy can be
deferred in children two years or older with mild symptoms. High-dose amoxicillin (80 to 90 mg per
kg per day) is the antibiotic of choice for treating acute otitis media in patients who are not allergic
to penicillin.

5. What is middle ear effusion? Enumerate intervention (medical and surgical). Give rationale.

 Middle ear effusion is the space behind the eardrum (sometimes called acute otitis media) is an
infection of the middle ear, the air-filled space behind the eardrum that contains the tiny
vibrating bones of the ear. Children are more likely than adults to get ear infections. Because ear
infections often clear up on their own, treatment may begin with managing pain and monitoring
the problem. Sometimes, antibiotics are used to clear the infection. Some people are prone to
having multiple ear infections. This can cause hearing problems and other serious complications.

 Otitis media with effusion, or swelling and fluid buildup (effusion) in the middle ear without
bacterial or viral infection. This may occur because the fluid buildup persists after an ear
infection has gotten better. It may also occur because of some dysfunction or noninfectious
blockage of the eustachian tubes.

 Role of eustachian tubes

The eustachian tubes are a pair of narrow tubes that run from each middle ear to high in the back of the
throat, behind the nasal passages. The throat end of the tubes open and close to:
 Regulate air pressure in the middle ear
 Refresh air in the ear
 Drain normal secretions from the middle ear
Swollen eustachian tubes can become blocked, causing fluids to build up in the middle ear. This fluid can
become infected and cause the symptoms of an ear infection.
In children, the eustachian tubes are narrower and more horizontal, which makes them more difficult to
drain and more likely to get clogged.

 Role of adenoids
Adenoids are two small pads of tissues high in the back of the nose believed to play a role in immune
system activity.
Because adenoids are near the opening of the eustachian tubes, swelling of the adenoids may block the
tubes. This can lead to middle ear infection. Swelling and irritation of adenoids is more likely to play a
role in ear infections in children because children have relatively larger adenoids compared to adults.

 Tympanocentesis is the trans-tympanic needle aspiration of ME contents. Aspiration of fluid

reduces ME pressure and is very effective in relieving pain. If a culture and sensitivity is to be
 performed on the aspirate, the external ear canal should be thoroughly cleaned and isopropyl
alcohol instilled into the external canal for one minute, then removed. Tympanocentesis can be
performed on infants using restraints, local or mild sedation. Older children will be more
comfortable if a local or general anesthesia is used.

 Insertion of pressure equalizing tubes (PET) is used to treat both AOM and OME. Myringotomy is
usually performed under general anesthesia. This is a clean procedure. A surgical prep is not
required unless cultures are to be taken. Incision is made in healthy tissue. Fluid is suctioned and
cultured if unusual pathogens are suspected. PETs are placed to prolong the time that drainage will
occur.

 The type of PET used depends on the intended duration. Both short-term and permanent
designs are available. Prevention of recurrent disease usually requires the PET to be in place for
12 months or more. A permanent PET design may be used if a duration of 12-18 months is
anticipated.•
 Post-op exam occurs about 2 weeks after insertion. If hearing is normal, re-examination may be
scheduled every six months until the tube is spontaneously extruded or removed.
 The effectiveness of adenoidectomy as a surgical treatment for OME and recurrent AOM has
thus far proved to be modest. The intent is to remove a source of infection and obstruction from
the nasopharyngeal opening of the eustachian tube. Tonsillectomy with or without
adenoidectomy has not been shown to be effective in preventing AOM or reducing the number
of days of OME.
 The benefits of surgical intervention must be weighed against the risks. The risks also include
those involved in anesthesia required to perform the procedures.

         II. CHARTING ( FOCUS: Knowledge deficit )

II. CHARTING: 
02/08/22
   7-3
 F> Deficient Knowledge R/T insufficient information
          
 D> Received patient in sitting position “ayaw ko na po bumalik yung sakit ng tenga ko pano po ba
gagawin ko?” confused and wondering, Temp: 37.0 C RR: 23 Spo2: 99% CR: 88bpm Bp: 100/80mmhg
Weight; 21kgs

A> Assessed motivation and willingness of patient to learn, determined priority of learning needs within
the overall care plan, Observed and note existing misconceptions regarding materials that is taught,
Determine the patient’s self-efficacy to learn and apply new knowledge. Explored reactions and feelings
about changes.

R> “susundin ko po lahat ng sinabe Ninyo sa akin at sa mama ko” mother and patient is now
knowledgeable how to prevent otitis media