The nurse is performing a focused interview with a client who has been cleaning the ears with a cotton-tipped applicator

Question

The nurse should educate the client about which of the following complications that can occur as a result of this practice? Standard Text: Select all that apply. 1. The client has a higher risk of developing otitis externa.
2. The client has a higher risk of developing tophi along the outer rim of the ears.
3. The client could perforate the tympanic membrane.
4. The client could require tympanostomy tubes.
5. The client's cerumen might become impacted.

Answer 1

3,5
Rationale 1: The client has a higher risk of developing otitis externa. Otitis externa is an infection of the client's outer ear. This client does not have an increased risk of developing otitis externa.
Rationale 2: The client has a higher risk of developing tophi along the outer rim of the ears. Tophi are small white nodules that are found on the helix or antihelix. These nodules are a sign of gout and contain uric acid crystals.
Rationale 3: The client could perforate the tympanic membrane. This client is at risk for perforating the tympanic membrane with the cotton-tipped applicator. The inside of the ear should not be cleaned. Cerumen moves to the outside of the ear canal naturally.
Rationale 4: The client could require tympanostomy tubes. Tympanostomy tubes are placed when clients develop repeated otitis media infections. These tubes help relieve middle ear pressure and allow drainage that occurs as a result of the infection. This client does not require tympanostomy tubes.
Rationale 5: The client's cerumen might become impacted. This client is at risk for impacting the cerumen within the ears with the cotton-tipped applicator. The inside of the ear should not be cleaned. Cerumen moves to the outside of the ear canal naturally.