Question

P.P. is a 4-year-old boy who presents to the pediatrician’s office with pain in his right ear.

SUBJECTIVE DATA

 Mom states that her son woke up in the middle of the night, crying, 2 nights ago. She gave the child ibuprofen, and he went back to sleep. Last night he woke up in pain, and he was inconsolable. She felt the physician should see him.

 Attends preschool program

 Lives with mother, who smokes in the car but not in the house

 Father estranged

OBJECTIVE DATA

 TM appears inflamed—it is red and may be bulging and immobile

 T = 100.3

 Last ibuprofen 3 hours ago

Respond to each question for the following scenario. Use rationale to support your responses.

1. What are three (3) assessments and/or questions that would be appropriate for a patient presenting with earache? Use complete sentences, and provide rationale for all answers.

2. What are three (3) risk factors associated with earaches for this age group?

3. Describe the differences and similarities between otitis media and otitis externa. Include what you might expect subjectively and objectively, answer in complete sentences, and provide rationale.

4. What are 2-3 possible causes of the earache in this patient? Use rationale to support your response.

Answer 1

1) Questions that are appropriate for patient presenting with earache:-

a)From how many days your child is suffering from earache?

b) Have you given any medicine for management of pain??

c) Is your child inserted something into the ears ?

2) Risk factors with earache at this age group are as follow:-

a) Infection may spread to mastoid sinus causing a much serious infection.

b) In children ,otitis media can reduce hearing at a time that is critical for speech and language development.

c)Ear drum may perforate.

3) Differences and similarities between otitis media and otitis external:-

- Otitis media is the inflammation of the middle ear and can be associated with infection caused by bacteria but in otitis external their is inflammation of external ear canal .

- Both may present simultaneously.

-Otitis media is common in children but otitis externa is common in adult due to swimming or clearing habit with pin or ear buds.In children common cause of otitis external is insertion of something into the ear canal.

- In otitis external their may be severe pain and modest reduction in hearing but in otitis media pain is not so severe.

4 ) Possible causes of earaches in this child are as follows:-

- It may be due infection of middle ear .

- It may be due to insertion of some foreign bodies into the ear.

-It may be due to excessive accumulation of earwax.