The nurse is performing an otoscopic examination of a 3-year-old child. As the nurse prepares to examine the client's tympanic membrane with the ototscope, the nurse would correctly choose which of the following techniques?
1. Pull the tragus up and back while inserting the otoscope.
2. Pull the ear lobe up and back while inserting the otoscope.
3. Pull the ear lobe down and back while inserting the otoscope.
4. Pull the tragus down and back while inserting the otoscope.
4
Rationale 1: The tragus should be manipulated up and back when examining an older child's tympanic membrane.
Rationale 2: The tragus, not the ear lobe, should be manipulated up and back when examining an older child's tympanic membrane.
Rationale 3: The nurse should not manipulate the child's ear lobe while inserting the otoscope. It would be more helpful to pull the child's tragus down and back to insert the otoscope correctly.
Rationale 4: In children under the age of 4 years, the tragus should be pulled down and back while the otoscope is inserted. This allows for the speculum to follow the curve of the auditory canal.
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