The nurse is performing an otoscopic examination on a child. Which are normal findings the nurse should expect? (Select all that apply.)
a. Ashen gray areas
b. A well-defined light reflex
c. A small, round, concave spot near the center of the drum
d. The tympanic membrane is a nontransparent grayish color
e. A whitish line extending from the umbo upward to the margin of the membrane
ANS: B, C, E
Normal findings include the light reflex and bony landmarks. The light reflex is a fairly well-defined, cone-shaped reflection that normally points away from the face. The bony landmarks of the eardrum are formed by the umbo, or tip of the malleus. It appears as a small, round, opaque, concave spot near the center of the eardrum. The manubrium (long process or handle) of the malleus appears to be a whitish line extending from the umbo upward to the margin of the membrane. The tympanic membrane should be light pearly pink or gray and translucent, not nontransparent. Ashen gray areas indicate signs of scarring from a previous perforation.
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