I need an explanation for this Nursing question to help me study.
Further Questions to Ask
Are you having any issues with you balance?
Do you have the sensation to itch your inner ear?
Have you had any drainage from your ear?
Have you noticed any changes in your hearing?
(Harvard Health Publishing, 2020).
Time Course and Different Causes of Ear Pain
Acute otitis externa is usually associated with simmer’s ear and occurs with a gradual onset over the course of 2-3 days after swimming (Center for Disease Control and Prevention, 2020). Acute otitis media may occur shortly after an upper respiratory infection and are usually symptoms show at day 3 or after (Seattle Children’s, 2020).
Age of Onset and Diagnostic Possibilities
The most common age for acute otitis media to occur is between 6 months to 2 years of age. This is due to the Eustachian tube swelling during inflammation, regurgitation or infection, leaving little room for drainage (Seattle Children’s, 2020). Although swimmers ear can occur in all ages, it normally occurs in older children, adolescents and adults rather than infants and toddlers.
Acute Otitis Media
Although diagnostic tests are rarely needed, pneumatic otoscopy may show decrease or absent tympanic membrane mobility.
NSAID- 325-650 PO Q 4 hours PRN pain.
Keflex (cephalosporin) 250-500 mg PO QID or
Dicloxacillin (penicillin) 250
(Keflex) 250 to 500 mg PO 4 QID
Omnicef (cephalosporin) 300 mg PO BID or
Augmenting XR (penicillin) 1000 mg PO BID
Cipro 500mg PO BID or
Ceftazidim 2 g IV Q 8-12 hours
Acute Otitis Externa
Although diagnostic test are rarely needed, fluid from the ear may be cultured and bacteria can be detected and tested for antibiotic sensitivity.
Perforated Tympanic Membrane
Ciprolfoxacin 0.3% & dexamethasone 0.1 % (Ciprodex oti). +6 months 4 gtts to affect ear BID for 7 days.
Non-Perforated Tympanic Membrane
Ciprofloxacin 0.2% & Hydrocortisone 1% (Cipro HC otic) 1yr+ 3 gtts to affected ear BID for 7 days
Colistin 3mg, neomycin 3.3 mg hydrocortisone acetate 10 mg, thonzonium bromide 0.5 mg (Cortisporin- TC otic).
Adutls: 4 gtts to affected ear TID for 7 days
TMJ (Trigeminal Neuralgia)
Neurological assessment that tests facial nerve reflexes can be performed and an MRI may detect multiple sclerosis or any tumor that may be the cause of TMJ.
Anticonvulsants (Tegretol, Carbatrol, others)
Antispasmodic agents (Gablofen & Lioresal)
Botox injections (onabotulinumtoxin A)
(Dunphy et al, 2015) & (National Organization for Rare Disorders, Inc.,2020).
Center for Disease Control and Prevention. (2020). Facts about swimmer’s ear.
Retrieved from https://www.cdc.gov/healthywater/pdf/
swimming/resources/pseudomonas-factsheet_swimmers_ear.pdf on 18 January 2020.
Dunphy, L., Windland-Brown, J., Porter, B., Thomas, D. (2015). Primary care: Art and
Science of Advanced Practice Nursing (4th ed.). Philadelphia. F.A. Davis.
Harvard Health Publishing. (2020). Retrieved from https://www.health.harvard.edu/a
_to_z/swimmers-ear-otitis-externa-a-to-z on 18 January 2020.
National Organization for Rare Disorders, Inc. (2020). Trigeminal Neuralgia. Retrieved
from https://rarediseases.org/rare-diseases/trigeminal-… / on 18 January 2020.
Seattle Children’s. (2020). Ear infection questions. Retrieved from
https://www.seattlechildrens.org/conditions/a-z/ea… on 18 January 2020.