The nurse is examining a 14-month-old child when the mother tells the nurse that the child cries frequently, has a fever, and is pulling at both ears. The nurse suspects the child has which of the following disorders from this assessment data?
1. Otitis media
2. Otitis externa
3. Hemotympanum
4. Tophi
1
Rationale 1: The auditory canal of infants is shorter and has an upward curve that persists until about the age of 3. In addition, their auditory tube is more horizontal than the adult, which leads to easier migration of organisms from the throat to the middle ear. Infants and children with otitis media often display the behavior of pulling at their ears.
Rationale 2: Otitis externa is an infection of the external auditory canal manifested by red, swollen ear canal, fever, and purulent drainage.
Rationale 3: Hemotympanum is a bluish tinge of the tympanic membrane indicating the presence of blood in the middle ear. It is usually associated with head trauma.
Rationale 4: Tophi are small white nodules on the helix or antihelix. These nodules contain uric acid crystals and are a sign of gout.
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