An elderly patient comes into the emergency department complaining of an earache

Question

The patient and has an oral temperature of 100.2ºF and otoscopic assessment of the ear reveals a pearly gray tympanic membrane with no evidence of discharge or inflammation. Which action should the triage nurse take next?
A) Palpate the patient's parotid glands to detect swelling and tenderness.
B) Assess the temporomandibular joint for evidence of a malocclusion.
C) Test the integrity of cranial nerve XII by asking the patient to protrude the tongue.
D) Inspect the patient's gums for bleeding and hyperpigmentation.

Answer 1

Ans: A
Feedback:
Older adults and debilitated patients of any age who are dehydrated or taking medications that reduce saliva production are at risk for parotitis. Symptoms include fever and tenderness, as well as swelling of the parotid glands. Pain radiates to the ear. Pain associated with malocclusion of the temporomandibular joint may also radiate to the ears; however, a temperature elevation would not be associated with malocclusion. The 12th cranial nerve is not associated with the auditory system. Bleeding and hyperpigmented gums may be caused by pyorrhea or gingivitis. These conditions do not cause earache; fever would not be present unless the teeth were abscessed.