100%
10 out of 10 points
10Out of 10 points
Time for this attempt: 10 minutes 25 seconds
10 minutes 25 seconds10:25Time for this attempt
Your Answers:
Otitis Media
A 2-year-old girl presents to the community health clinic accompanied by her grandmother. Her grandmother explains that the client awoke crying in the early hours of the morning. The child was inconsolable and was observed pulling at her right ear lobe and saying “ouch!.” Her grandmother reports administering a dose of children’s acetaminophen about 6 hours ago to help relieve the pain.
A review of the client’s chart reveals she was treated conservatively for a viral upper respiratory infection five days ago; however, her grandmother explains that symptoms have mostly resolved with the exception of a slight runny nose.
The nurse prepares to perform a focused physical examination of the client.
Results for question 1.
1
2 / 2 points
Which of the following would be most appropriate for the nurse to perform to assess the ears of a 2-year-old child?
Correct answer:
Pull the ear lobe down and out during inspection of the ear canal.
Pull the ear lobe up and back during inspection of the ear canal.
, Not Selected
Results for question 2.
2
2 / 2 points
Which of the following would be most appropriate for the nurse to perform to assess the ears of a 2-year-old child?
Examine the affected ear first.
, Not Selected
Correct answer:
Examine the unaffected ear first.
Results for question 3.
3
2 / 2 points
Which of the following would be most appropriate for the nurse to perform to assess the ears of a 2-year-old child?
Collect the opthalmascope for the examination.
, Not Selected
Correct answer:
Collect the otoscope for the examination.
Results for question 4.
4
2 / 2 points
Which of the following would be most appropriate for the nurse to perform to assess the ears of a 2-year-old child?
Inspect the Stenson’s ducts.
, Not Selected
Correct answer:
Inspect the tympanic membrane.
Results for question 5.
5
2 / 2 points
Which of the following would be most appropriate for the nurse to perform to assess the ears of a 2-year-old child?
Palpate the stapes and the incus.
, Not Selected
Correct answer:
Palpate the pinna and the tragus.
Feedback
General Feedback
Rationale:
When preparing to examine the ear canal of a pediatric patient aged three (3) or younger, the ear lobe should be pulled down and outward to straighten the ear canal. This differs from the examination of the clients over the age of three where the ear lobe would be positioned up and back. The variation in recommended positioning is related to the development of the ear canal. Around the age of three, the external auditory canal matures into a downward, forward position.
Examination of the well ear should be performed first. This allows the nurse to identify the “normal” anatomy of the client’s inner ear for comparison with the affected ear. It is also a helpful technique in children who may be less inclined to allow an internal examination of the well ear if the examination of the affected ear was uncomfortable.
The otoscope is the device used for inspection of the internal ear canal. The ophthalmoscope is the device used for inspection of fundus of the eye. Refer to your health assessment textbook for photos of each of these devices.
The pinna and tragus are external structures of the ear that can be easily palpated with no special equipment. The incus and stapes are two of the tiny bones or ossicles of the inner ear. The ossicles include the malleus, incus, and stapes.