The nurse is caring for a happy, playful baby who has been treated for recurrent ear infections
Upon assessment, the nurse finds fluid in the middle ear, but the baby has no apparent signs of local or systemic illness. The nurse suspects that the baby is experiencing mild hearing loss, because the father must speak to her a couple of times before the baby responds. The nurse should suspect
a. acute otitis media.
b. otitis media with effusion.
c. acute otitis externa.
d. otomycosis.
ANS: B
Otitis media with effusion (OME) is characterized by fluid in the middle ear but without evidence of local or systemic illness. OME may cause mild hearing loss, but it does not cause pain. The condition can persist for weeks to months after OME has resolved.
Acute otitis media is characterized by inflammation and fluid in the middle ear, pain, fever, vomiting, irritability, impaired hearing, sleeplessness, and otorrhea.
Acute otitis externa, also known as swimmer's ear, is a bacterial infection of the external auditory canal. It is marked by a rapid-onset ear pain with pruritus, impaired hearing, purulent drainage, and increased tenderness upon manipulation of the auricle.
Otomycosis, or fungal otitis externa, manifests as intense pruritus and erythema and may or may not involve pain and hearing loss.
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