An elderly patient comes into the emergency department complaining of an earache. The patient and has an oral temperature of 100.2 degrees Fahrenheit

Question

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 client's parotid glands to detect swelling and tenderness.
B) Assess the temperomandibular joint for evidence of a malocclusion.
C) Test the integrity of the12th cranial nerve by asking the client to protrude his tongue.
D) Inspect the client's gums for bleeding and hyperpigmentation.

Answer 1

Ans: A
Feedback: Older adults and debilitated clients of any age who are dehydrated or taking medications that reduce saliva production are at risk for parotitis. Symptoms include fever and tenderness and swelling of the parotid glands. Pain radiates to the ear. Pain associated with malocclusion of the temperomandibular 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.