GNM II YEAR MSN II ENT

1. OTITIS
EXTERNA

2. DEFINITION
OTITIS EXTERNA is an
inflammation or infection of
the epithelium of the external
auditory canal or the auricle of
the external ear. It is also
called as ‘swimmer’s ear”. It
may acute and chronic.

3. ETIOLOGY
It can be caused by
allergy, bacteria,
fungi, viruses and
trauma.

4. ALLERGY:
From nickel or chromium
in earrings
 CHEMICALS in hair spray,
cosmetics, hearing aids and
medication especially
sulphonamide and neomycin
are common source of allergy.

5.  TRAUMA from cleaning or
scratching the ear canal with a
foreign object such as cotton
swab, pins, causes initial break
in the skin.
 certain activity allow moisture
to became trapped into ear
creating medium for infection
eg: use of ear phones, ear
plugs and stethoscope.

6. BACTERIAL AGENTS are
staphylococcus auras,
pseudomonas aeruginosa and
staphylococcus pyogenes.
COMMON FUNGUS is candida
albicans and aspergillus may
also be causes.
It is more prevalent during hot
and humid climate.

7.  Excessive swimming may
wash out the protective
cerumen, remove skin lipids
and lead to secondary
infection.
 Malignant external otitis is an
infection caused by
P.Aeruginosa. The infection
occurs mainly in elderly
patients with diabetes.

8. CLINICAL MANIFESTATION
Pain [ otalgia ] or
discomfort, tenderness,
discharge.
Edema, redness, erythema,
scaling, pruritus, odema,
watery discharge.
CIRCUMDUCTION SIGN

9. Drainage from the ear may
be serosanguineous or
purulent
 caused by Pseudomonas,
drainage will be green or
musty smell.

10. ASSESSMENT
 Collect SUBJECTIVE DATA include the
onset, duration and severity of pain and
regarding home remedies used to treat
infection.
Knowledge of preventive measures also
assessed
 OBJECTIVE DATA include noting a
discharge which may be watery or
yellow and tenacious with odour.
Discharge may be black if it is fungal
infection.
PALPATION of the external ear may
cause pain.

11. DIAGNOSTIC
TEST
OTOSCOPE LIGHT WITH
LARGEST SPECULUM
A culture of the exudate is
obtained to identify bacteria,
viral or fungal organisms.

12. MEDICAL MANAGEMENT
Oral analgesics such as codeine
may be used if pain is severe
 Topical antibiotics include
10,000/ml of polymyxin B and
0.5% neomycin and
chloramphenical
 Nystatin used for fungal
infections

13. Corticosteroids [ 1%
hydrocortisone] may be used
to reduce oedema and allow
antibiotics to penetrate.
 warm, moist compresses or
heat may be applied and may
provide systemic antibiotics
also.

14. NURSING
MANAGEMENT
 Careful handling and disposal of
material saturated with drainage is
important.
 Hands should be washed before
and after administration of otic
drops

15. The drops should administered
at room temperature because
cold drops can cause dizziness
due to stimulation of semilunar
canals.
A wick is inserted into the ear
canal to prevent loss of
medication from the canal
maintain continuous
absorption of the medicine.

16.  the tip of the dropper shoul
not touch the ear during
administration to prevent
contamination of entire bottle
of drops.
The position should be
maintained for 2 min after
eardrops administration to
allow dispersion of drops.

17. NURSING DIAGNOSIS
Pain related to inflammatory
process
i. Apply warm compresses as
ordered
ii. Administer prescribed
analgesics and instil ordered
ear medication.

18. THANK
YOU