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NURSING CARE PLAN The Child with Otitis Media …

Alterations in Eye, Ear, Nose, and Throat Function 707. NURSING care plan The Child with Otitis Media GOAL INTERVENTION RATIONALE EXPECTED OUTCOME. 1. Pain related to inflammation and pressure on tympanic membrane NIC Priority Intervention: Pain NOC Suggested Outcome: Pain Management: Alleviation or Level: Amount of reported or reduction in pain to a level of comfort demonstrated pain. acceptable to patient and family. The Child or parent will indicate Give analgesic such as Analgesics alter perception or Verbal Child states that pain is absence of pain. acetaminophen. Use analgesic response to pain. relieved. Nonverbal Child has eardrops. improved disposition and comfort. Have the Child sit up, raise head on Elevation decreases pressure from pillows, or lie on unaffected ear. fluid. Apply heating pad or warm hot Heat increases blood supply and water bottle. reduces discomfort. Have the Child chew gum or blow Attempts to open the eustachian on balloon to relieve pressure in tube may help aerate the middle ear.

708 CHAPTER 19 and disillusioned because of the inability of the health care system to cure the child and may fear a permanent hearing impairment.Reassure parents that as the child grows older,the re-

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Transcription of NURSING CARE PLAN The Child with Otitis Media …

1 Alterations in Eye, Ear, Nose, and Throat Function 707. NURSING care plan The Child with Otitis Media GOAL INTERVENTION RATIONALE EXPECTED OUTCOME. 1. Pain related to inflammation and pressure on tympanic membrane NIC Priority Intervention: Pain NOC Suggested Outcome: Pain Management: Alleviation or Level: Amount of reported or reduction in pain to a level of comfort demonstrated pain. acceptable to patient and family. The Child or parent will indicate Give analgesic such as Analgesics alter perception or Verbal Child states that pain is absence of pain. acetaminophen. Use analgesic response to pain. relieved. Nonverbal Child has eardrops. improved disposition and comfort. Have the Child sit up, raise head on Elevation decreases pressure from pillows, or lie on unaffected ear. fluid. Apply heating pad or warm hot Heat increases blood supply and water bottle. reduces discomfort. Have the Child chew gum or blow Attempts to open the eustachian on balloon to relieve pressure in tube may help aerate the middle ear.

2 Ear. 2. Infection related to presence of pathogens NIC Priority Intervention: Infection NOC Suggested Outcome: Risk Control: Minimizing the acquisition Control: Actions to eliminate or and transmission of infectious agents reduce health threats. The Child will be free of infection. Encourage breastfeeding of infants. Breastfeeding affords natural The Child 's temperature is normal, immunity to infectious agents. symptoms have disappeared, and Instruct the parents to administer Taking antibiotics as prescribed tympanic membrane shows no signs antibiotics exactly as directed and minimizes chance for overgrowth of infection. to complete prescribed course of of pathogens. medication. Telephone the parents 2 3 days If symptoms have not improved in after initial examination. 36 hours, treatment should be evaluated. Examine ear 3 4 days after Check-up determines if treatment is completion of antibiotic treatment, effective.

3 Or if symptoms worsen in Child on symptomatic treatment. 3. Risk for Caregiver Role Strain related to chronic disease NIC Priority Intervention: Caregiver NOC Suggested Outcome: Support: Provision of necessary Caregiver Performance: Provision support, information, and advocacy to by family care provider of health care facilitate care by parents. for Child . The parents will manage the Child 's Determine the parents' ability to Many parents can treat children at The parents express confidence about condition with minimal stress. manage condition. Provide home. Knowledge of condition treating the Child and state that stress frequent information and feedback. allows parents to make informed is reduced. decisions and to manage condition effectively. Encourage parental input in Active participation increases managing care . confidence and ability to manage condition. Listen carefully to parental Reacting empathically encourages expressions of frustration and parents to communicate.

4 Fatigue and try to understand parents' feelings. (continued). 708 CHAPTER 19. NURSING care plan The Child with Otitis Media (continued). GOAL INTERVENTION RATIONALE EXPECTED OUTCOME. 4. Risk for Infection related to knowledge deficit about infection in children NIC Priority Intervention: Infection NOC Suggested Outcome: Control: Minimizing the acquisition Knowledge: Extent of understanding and transmission of infectious agents conveyed about infectious disease prevention. The parents will state understanding Teach family members to cover Good hygiene prevents spread of Parents express understanding of of preventive measures. mouths and noses when sneezing pathogens. measures to lead fewer to infections. or coughing and to wash hands frequently. Have parents isolate sick children. Encourage optimal nutrition, rest, Physical well-being helps the body and exercise. fight disease. Position bottle-fed infants upright Elevated position prevents injection when feeding.

5 Do not prop bottles. of milk and pathogens into the eustachian tube. Eliminate allergens and upper Fewer irritants and allergens may respiratory irritants such as decrease susceptibility to tobacco, smoke, and dust. respiratory infections. Secondhand smoke contributes to higher incidence of Otitis Media . 5. Risk for Altered Growth and Development related to hearing loss NIC Priority Intervention: NOC Suggested Outcome: Growth Developmental Enhancement: and Development: Milestones of Facilitating optimal growth and developmental progression. development of the Child . The Child will have normal hearing. Assess hearing ability frequently. Monitoring detects hearing loss The Child 's general health and hearing early. improve, and incidence of condition decreases. The Child will have normal motor and Assess motor and language Early detection of developmental The Child has language and motor language development.

6 Development at each health care delays can lead to appropriate development within norms for age visit. intervention. group. and disillusioned because of the inability of the health care system to cure the Child and may fear a permanent hearing impairment. Reassure parents that as the Child grows older, the re- current infections eventually cease. Teach them that asking for courses of antibiotics for every infection may not be the treatment of choice. Parents of children with tympanostomy tubes need to be taught how to care for the Child and what symptoms to report. Evaluation Expected outcomes of NURSING care for the Child with Otitis Media include: Return to normal sleep and feeding patterns. Maintenance of normal hearing Effective pain and temperature management Understanding of treatment regimen by parents. HEARING IMPAIRMENT. Approximately 1 million children in the United States have some form of hearing impair- ment.

7 These hearing impairments are expressed in terms of decibels (dB), which are units of loudness, and rated according to severity (Table 19-7). Children who have only a mild hear.


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