Otitis Media Pediatrics Toddler – NSG 5441 Reflection Assignment/Discussion – Solution

Otitis Media Pediatrics Toddler – I recently encountered a ten-month-old boy suffering from otitis media, commonly known as ear infections…

NSG 5441 Reflection Assignment/Discussion

Students will post reflection assignments in Weeks 3, 7 and 10. Students should reflect on their clinical experiences, offering clinical explanations, self-reflection, and information to share with your peers regarding what you have learned. These assignments will be in discussion format, and will require peer feedback. Initial reflection posts are due on Day 3 at 11:59 pm ET, with peer responses due on Day 7 at 11:59 pm ET. 

Solution

Otitis Media Pediatrics Toddler

Describe the Experience

I recently encountered a ten-month-old boy suffering from otitis media, commonly known as ear infections. He was brought to the clinic accompanied by his parents and older sister, aged six years. The mother reported that the infant has a fever, loss of appetite, pain in the right ear, and irritability. From the symptoms presented, it was clear the patient had an ear infection, but there was a need for further diagnosis for confirmation and to provide the right treatment.

Description of Thoughts and Feelings

I probed further on the infant’s recent experiences for a better diagnosis. The patient is a second born in a family of two and is left in a child care center when his parents go to work and his sister to school. He got a flu infection while at the care center a week ago and visited the clinic for flu treatment. The treatment helped stop the mucous membranes’ swelling in the throat and nose.

After that, however, he started presenting symptoms of decreased activity, vomiting, restless sleep, rubbing the ear, and lack of appetite, which made the parents seek medical attention. With these additional symptoms and the patient’s recent interactions and condition, I felt that the infant had an ear infection in the right year. However, I thought it would be best to perform a physical examination to confirm the extent of the condition.

Evaluation

I used an otoscope to look into the patient’s ear. I also removed ear wax to better view the eardrum. I found that the tympanic membrane was bulging and inflated. Additionally, although the patient did not have any ear discharge leaving the outer ear, his eardrum was covered in fluid. The tympanic membrane was yellow and had a single perforation and acute otitis media vital signs (De Corso et al., 2021). However, the left ear was okay and did not have any signs of infection.

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Analysis

The patient had an ear infection based on the physical examination and medical history. The main risk factor for the condition is viral respiratory tract infections, including flu and cold. The patient had previously visited the facility for a flu treatment which could have led to the ear infection. These infections mainly cause swelling of the mucous membranes on the nose and throat, making it difficult for the infant to clear the number of bacteria in the nose.

They can also impair the Eustachian tube, which maintains the normal pressure in the ear. In this regard, it may change the pressure in the middle ear, causing the formation of effusion and bacteria, which causes inflammation. In this regard, the patient’s condition was contributed by a flu infection.

Conclusion and Learning

According to Park et al. (2021), otitis media is the second most common condition affecting children after upper respiratory infections. Approximately 16 million children visit clinics due to ear infections, and most of them are prone to have recurrent ear infection problems later in their childhood. Specifically, Van Ingen et al. (2019) highlight that one-third of children experience at least six episodes of the condition by their seventh birthday.

Nonetheless, I learned that apart from viral respiratory infections, the condition can be attributed to developmental problems in the endotracheal system and immature immune system that may contribute to otitis media development (Vorobyeva et al., 2022). For this reason, it is important to provide the necessary treatment on time to reduce the risk of future ear infections and adverse effects, including hearing loss, facial paralysis, petrositis, meningitis, brain abscess, and subdural empyema (Vorobyeva et al., 2022).

Action Plan

The main objectives of the treatment are to reduce pain and avoid complications that may adversely affect the patient’s health. For this reason, I prescribed amoxicillin, 85 mg/kg per day, which should be taken two times a day for a week (Scott et al., 2019). I also educated the parents on the risk factors they should avoid and the appropriate use of antibiotics.

References

De Corso, E., Cantone, E., Galli, J., Seccia, V., Lucidi, D., Di Cesare, T., Ottaviano, G., Sergi, B., Paludetti, G., & Fetoni, A. R. (2021). Otitis media in children: Which phenotypes are most linked to allergy? A systematic review. Pediatric Allergy and Immunology, 32(3), 524-534. https://doi.org/10.1111/pai.13431

Park, M., Han, J., Park, J., Jang, M., & Park, M. K. (2021). Particular matter influences the incidence of acute otitis media in children. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-021-99247-3

Scott, A. M., Clark, J., Julien, B., Islam, F., Roos, K., Grimwood, K., Little, P., & Del Mar, C. B. (2019). Probiotics for preventing acute otitis media in children. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd012941.pub2

Van Ingen, G., Le Clercq, C. M., Touw, C. E., Duijts, L., Moll, H. A., Jaddoe, V. W., Raat, H., Baatenburg de Jong, R. J., & Van der Schroeff, M. P. (2019). Environmental determinants associated with acute otitis media in children: A longitudinal study. Pediatric Research, 87(1), 163-168. https://doi.org/10.1038/s41390-019-0540-3

Vorobyeva, M., Karpova, E., Tulupov, D., Naumov, O., & Zakharova, I. (2022). Risk factors and clinical features of the course of recurrent acute otitis media in children. Vestnik otorinolaringologii, 87(1), 9. https://doi.org/10.17116/otorino2022870119

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