A 22 year old male presented with left earache and discharge for 2 weeks. On examination, his left tympanic membrane was bulging and erythematous. He was diagnosed with acute otitis media. Treatment involves topical and oral antibiotics as well as analgesics to manage pain. Surgical drainage may be required if symptoms persist despite medical management. The nurse's role includes assessing pain, monitoring for complications, providing patient education, and ensuring a safe recovery.
otitis media is the inflammation of the ear drum or tympanic membrane this topic include its definition , etiology, pathophysiology, clinical manifestation, diagnosis and its treatment which can be used by nursing students for taking care of the patient suffering from otitis media and for learning for their examination and knowledge purpose
and care of the child with acute otitis media and chronic otitis media and make their family aware about the complication of the otitis media like hearing loss meningitis
Retina is a layer of tissue at the back of the eye, which helps to see images focused on it by the cornea and lens. Retinal Detachment is an eye disorder, wherein the retina gets separated from the underlying layer of blood vessels, which supplies oxygen and other nutrients to it.
Nosebleeds are very common in young children, affecting most at some time or another. From the outset, it is important to be aware that nosebleeds will often settle down on their own, sometimes requiring medical treatment, but that major underlying causes (blood clotting problems or abnormalities in the nose) are very rare.
otitis media is the inflammation of the ear drum or tympanic membrane this topic include its definition , etiology, pathophysiology, clinical manifestation, diagnosis and its treatment which can be used by nursing students for taking care of the patient suffering from otitis media and for learning for their examination and knowledge purpose
and care of the child with acute otitis media and chronic otitis media and make their family aware about the complication of the otitis media like hearing loss meningitis
Retina is a layer of tissue at the back of the eye, which helps to see images focused on it by the cornea and lens. Retinal Detachment is an eye disorder, wherein the retina gets separated from the underlying layer of blood vessels, which supplies oxygen and other nutrients to it.
Nosebleeds are very common in young children, affecting most at some time or another. From the outset, it is important to be aware that nosebleeds will often settle down on their own, sometimes requiring medical treatment, but that major underlying causes (blood clotting problems or abnormalities in the nose) are very rare.
Abnormal development or deformities of the ear anatomy can cause a range of complications, from cosmetic issues to hearing and development problems.
An estimated 6 to 45 percent of children are born with some sort of congenital ear deformity.
mastoiditis is the inflammatory condition of the mastoid bone and this topic include its definition, etiology, clinical feature and its treatment this ppt can be used by bsc and gnm nursing student for taking care of the patient suffering from mastoiditis and for learning and writing purpose for their exam
ototoxicity is also known as the poisoning of the ear and this is a chronic condition which need proper treatment as it cannot be detected early so knowledge of this condition can be useful for making differential diagnosis and proper treatment of the patient for the nursing students bsc and gnm and also can be used for their learning understanding and for their exam too
oto sclerosis is the hardning of the ear bone or abnormal spongy bone growth inside ear this topic include its definition , etiology, pathophysiology, clinical menisfestation, diagnosis and its treatment which can be used by nursing students for taking care of the patient suffering from otosclerosis and for learning for their examination and knowledge purpose
Abnormal development or deformities of the ear anatomy can cause a range of complications, from cosmetic issues to hearing and development problems.
An estimated 6 to 45 percent of children are born with some sort of congenital ear deformity.
mastoiditis is the inflammatory condition of the mastoid bone and this topic include its definition, etiology, clinical feature and its treatment this ppt can be used by bsc and gnm nursing student for taking care of the patient suffering from mastoiditis and for learning and writing purpose for their exam
ototoxicity is also known as the poisoning of the ear and this is a chronic condition which need proper treatment as it cannot be detected early so knowledge of this condition can be useful for making differential diagnosis and proper treatment of the patient for the nursing students bsc and gnm and also can be used for their learning understanding and for their exam too
oto sclerosis is the hardning of the ear bone or abnormal spongy bone growth inside ear this topic include its definition , etiology, pathophysiology, clinical menisfestation, diagnosis and its treatment which can be used by nursing students for taking care of the patient suffering from otosclerosis and for learning for their examination and knowledge purpose
Chronic suppurative otitis media is a long standing infection of a part or whole of the middle ear cleft characterized by continuous or intermittent discharge through a persistent tympanic membrane perforation.
Incidence is higher in developing countries b/c of
Poor Socioeconomic standards, poor Nutrition, lack of health education
Affects both sexes
Affects all age groups
It is divided into two types
TUBOTYMPANIC : also called the safe or benign type; it involve anteroinferior part of middle ear cleft; i.e eustachian tube and mesotympanum and is associated with central perforation.
ATTICOANTRAL: also called unsafe or dangerous type; it involves posterosuperior part of the middle ear cleft; i.e. attic, antrum and mastoid. And is associated with an attic or marginal perforation and this type of CSOM is often associated with bone-eroding process such as cholesteatoma, granulation or osteitis
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
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- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
How to Give Better Lectures: Some Tips for Doctors
Otitis media syanthika medsurg
1. Case Scenario
22 year old boy was brought to the E.N.T. clinic with recurrent
nasal symptom of cold, stuffiness and rhinorrhoea since 1/2
months.
• He complained of 2 weeks back of an episode of left earache
followed by discharge which was profuse and mucoid. Pain was
severe at the middle of the night due to which he couldn’t sleep.
5. Definition
Otitis Media is the inflammation of part or all of the lining
mucosa of the middle ear cleft i.e the eustachian tube,
tympanic cavity, attic, aditus, antrum and mastoid air cells
6.
7. Acute
OTITIS
MEDIA
Acute OTITIS MEDIA without
effusion
Acute OTITIS MEDIA with
effusion
Aero OTITIS MEDIA
Chronic
OTITIS
MEDIA
Chronic Suppurative Otitis
media
Tubercular otitis media
Syphilitic otitis media
CLASSIFICATION OF OTITIS MEDIA
8. ACUTE OTITIS MEDIA
(without effusion)
• It is the acute inflammation of the mucosal lining of the middle ear
cleft.
• Basically affects the infants and the younger age group.
Normal AOM
9. Predisposing factors
• Younger age group
• Recurrent attacks of common cold.
• URI
• Tonsillitis
• Adenoids
• Chronic exposure to secondhand smoking.
• Chronic rhinitis & sinusitis
• Nasal Allergy
• Tumours of nasopharynx
• Cleft palate
• Eustachian tube dysfunction
• Medical conditions like Down syndrome, cystic fibrosis.
10. Aetiology
• Extension of Infection from nasopharynx (upper respiratory tract
infections)via eustachion tube
• Through Perforation or Grommet
• Often starts with Viral infection
• (RSV,Rhinovirus,Parainfluenza virus, Influenza virus) followed by
• Bacterial infection
• (Strep.Pneumoniae, H.Influenza,M.catarrhalis & Staph. Aureus)
• Inflammation of surrounding structures (rhinosinusitis)
• Allergic reaction ( allergic rhinitis)
18. Aero OTITIS MEDIA
• Also known as Otitis Barotrauma
• It is a non-suppurative condition owning to the failure of
eustachian tube to maintain middle ear pressure at ambient
atmospheric level.
19. Clinical features
1. Severe Ear ache
2. Tinnitus
3. Tymphanic membrane retracted and
congested
4. Hearing loss
20. Chronic Suppurative Otitis Media
It is the chronic (>3 months) inflammation of the periosteal lining of the
middle ear cleft.
21. Risk factors for CSOM
1. History of multiple episodes of acute OTITIS MEDIA
2. Living in crowded places
3. Member of a large family
24. Profuse, Mucoid,
Odourless
Scanty, Purulent, Foul
smelling
Central Attic or marginal
Pale Red and fleshy
Absent Present
Rare Common
Audiogram Mild to moderate
conductive deafness
Conductive or mixed
deafness
Criterion Tubotymphanic Atticoantral
Common
Discharge
Perforation
Granulation
Polyp
Cholesteatoma
Complications
Uncommon
25. Chronic Suppurative OTITIS MEDIA-
Tubotymphanic
Types-
1.Active- when the ear is discharging.
2. Inactive- when the ear is dry.
Characteristics-
1. Perforation is almost always central.
2.Mucosa is inflamed and edematous.
3. Polyps are seen.
4. Ossicular chain is usually intact.
26. Chronic Suppurative OTITIS MEDIA-
Atticoantral
This type of C.S.O.M. is considered as dangerous / unsafe type.
This type of CSOM is associated with formation of Cholesteatoma,
granulation tissues & occasionally cholesterol granulomas.
If left untreated, it leads to serious complications involving the temporal
bone and cranial cavity & brain.
27. What is Cholesteatoma?
Cholesteatoma
is simply “skin in wrong place”.
Aural cholesteatoma is a bag of stratifiedsquamous epithelium
within the middle ear which contains desquamated epithelial debris
(mainly keratin) and germs.
(This term is a misnomer: it is neither a tumor nor it contains
cholesterol crystals)
The correct term: Keratoma
29. Pathophysiology of CSOM
Irritation and
inflammation
of the middle
ear mucosa
Mucosal edema Mucosal ulceration
Breakdown
of the
mucosal
epithelium
Granulation
tissue
formation
Destruction of
the margins of
the bone
margins
CSOM
30. Clinical features of CSOM
1. Otorrhoea
2. Otalgia
3. Fever
4. Malaise
5. Vertigo
6. Hearing loss in the affected ear
7. Perforation of tympanic membrane
8. Facial paralysis
9. Headache
31. Tubercular otitis media
Secondary to pulmonary Tb
Clinical features :-
Slow onset of disease-
--Painless condition
--Discharge is thin, scanty and odourless
--Tympanic membrane is pale yellow to rosy pink in colour.
--Perforations in the membrane are usually multiple and
may be associated with pale granulations.
--Hearing loss is disproportionate to other symptoms.
33. Syphylitic OTITIS MEDIA
Rare condition caused by Spirochetes reaching
middle ear cleft through eustachian tube or blood
borne.
Clinical features-
--Sensorineural hearing loss
--Tinnitus
--Vertigo
--Bone necrosis
--Sequestrum formation
34. Diagnostics and Investigations
1. Medical history of previous Otitis Media
2. Otoscopic Examination
3. CT scan –
Temporal bone CT scanning may reveal osseous
erosion of the scutum, ossicles, ear canal, mastoid, otic
capsule, fallopian canal, or tegmen, which typically
suggests cholesteatoma.
Also includes subperiosteal abscess or intracranial
abscess, and, in some cases, lateral sinus thrombosis.
4.MRI scan-
reveal dural inflammation, sigmoid sinus
thrombosis, labyrinthitis, and extradural and intracranial
abscesses.
35. Diagnostics and Investigations… .contd
5. Audiometry and Audiogram-
Conductive hearing loss is expected, but mixed or sensorineural
hearing loss may indicate more extensive disease and should alert the
treating physician of impending complications, including labyrinthitis.
6. Mastoid X-ray
7. Tympanogram
8. Middle ear Endoscopy
47. Surgical management
General indications for surgery-
1. Patients who donot respond to topical therapy
2. Perforation that persists beyond 6 weeks
3. Otorrhea that persists for longer than 6 weeks
despite antibiotic use
4. Cholesteatoma formation
5. Radiographic evidence of chronic mastoiditis, such
as coalescent mastoiditis
6. Conductive hearing loss.
48. A. Myringoplasty
It is the operation specifically designed to close tympanic membrane
defects.
The approach to the ear can be transcanal, endaural, or retroauricular.
-The transcanal approach requires less surgical exposure and leads to
faster healing.
-The endaural approach can improve exposure in ears with a lateral soft
tissue or cartilage overgrowth, but again, it tends to limit the surgical view.
-The retroauricular approach allows for maximal exposure but requires an
external skin incision.
49.
50. B. Tympanoplasty
This surgical approach contains tow techniques-
1.Underlay technique involves placing the graft material underneath (or
medial to) the eardrum.
2. Overlay technique involves grafting lateral to the eardrum.
51. C. Ossiculoplasty
Ossiculoplasty refers to the surgical process of restoring the hearing
system between the tympanic membrane and oval window.
It involves the use of grafts and prosthesis.
52.
53. D. Mastoidectomy
It consists of the removal of the outer wall of the
mastoid cortex and the exteriorization of all the
mastoid air cells.
54. Surgical complications
The complications of myringoplasty and tympanoplasty are-
- Infection
- Hematoma
- Taste disturbance owning to damage of chordae tympani nerve
- Ear numbess
- Conductive hearing loss
- Senironeural hearing loss
- Vertigo
- Facial paralysis
55. Surgical complications… contd
The complications of mastoidectomy are-
1. CNS leakage
2. Intracranial complications-. abscess, meningitis.
56. Nursing management
Nursing Assessment
Assessment of patient with otitis media include the following:
History
Assess if there is a history of trauma to the ears, affected siblings, a history of
cranial/facial defects or any familial history of otitis media.
Physical examination
The patient’s ear is examined with an otoscope by pulling the ear upwards and
back to straighten the ear canal.
If the patient is suffering from hearing loss, the nurse should be alert for the
following- Speech deterioration, Fatigue, Insecurity, Loneliness, Social
Withdrawal.
57. Subjective Data Objective data
1. Pain in the ear
2. Ear discharge
3. Nasal congestion
4. Sleepless night due
to ear pain.
5. Fever for 2 weeks.
1. Facial grimacing, irritable
2. Pain rate -7/10
3. Vital signs-
-Pulse rate- 120beats/min
-Temperature-100 °F
-Respiratory rate- 26breaths/min
4.Tymphanic membrane appears red
with bilateral bulge.
5. Pharynx slightly red without exudate.
6. Discharge appears mucoid and
purulent.
58. Nursing Diagnoses
1.Acute pain related to the inflammation of the middle ear as evidenced
by facial grimacing and verbalisation of the patient.
Interventions-
* Assess the intensity, duration of the pain.
* Assess the possible causes responsible for pain.
* To rate the intensity of pain according to scale.
* To record and monitor vital signs closely.
* To assist with divertional therapy.
* To administer with hot compression, as per order.
* To administer analgesics, as per order.
Pre-operative Nursing management
59. 2.Impaired verbal communication related to effects of
hearing loss as evidenced by neurological assessment.
Interventions-
* Assess reasons for impaired verbal communication.
* To make atmosphere conducive to communication.
* To assist with pen and paper to enable patient with communication.
* To observe for non-verbal communication and gestures.
* To speak in low and attentive manner.
* To maintain a specific routine for speech practice sessions.
* To arrange for speech and audio rehabilitation measures.
60. 3.Disturbed sensory perception related to obstruction, infection of the
middle ear, or auditory nerve damage as altered sensorium of patient.
Interventions-
* Assess for possible signs of obstruction in middle ear.
* Assess signs for auditory nerve damage.
* To assess with diagnostic procedures- Ctscan, MRI.
* To assess for hearing ability.
* To assess for any visible discharge from ear.
* To arrange for calm and quiet environment.
* To observe for non- verbal communication and gestures.
61. 4.Anxiety related to health status and impending surgery as
evidenced by increased apprehension of health deterioration.
Interventions-
* Assess the level and reasons for anxiety.
* Prepare the patient for surgery.
* Provide bed and sleep.
* Provide complete information such as possible outcome, side-effects of
the surgery.
* Encourage patient and family members to ventilate concerns about the
health status.
* To arrange discussion sessions to ventilate grievances.
* To introduce patients with the similar diagnosis and with better benefits
and outcomes.
* Reassessment.
62. 5. Risk for injury related to hearing loss and loss of balance.
Interventions-
* Maintain a safe environment.
* Assist the patient with ADLs.
* Assist with locomotion and movement.
63. 6. Risk of infection related to presence of pathogens.
Interventions-
* To monitor and record vital signs.
* To perform hand wash during patient handling.
* To avoid invasive procedures.
* To maintain aseptic measures during invasive procedures.
* To assess the discharge from ear and send for culture sensitivity.
64. Post-operative Nursing management
1. Acute pain related to surgical procedure as evidenced by
patient’s verbalisation.
Interventions-
* Assess duration, intensity and reason for pain.
* Rate the pain.
* Monitor vital signs, signs of inflammation.
* To elevate head at 30 to 45°.
* To administer hot compression, as per order.
* To assess the site of incision, any signs of discharge.
* To assist with divertional therapy.
* To administer analgesics, as per order.
65. 2. Impaired verbal communication related to hearing loss secondary
to surgery as evidenced by edema, accumulation of tissue fluid in the
middle ear.
Interventions-
* Assess the causes of impaired verbal communication.
* Elevation of head at 30-45° to relieve edema.
* To maintain a calm and quiet environment.
* To speak in clear and soft language with the patient.
* To observe for non-verbal clues.
* To educate family members about effective ways of communication.
66. 3. Impaired tissue integrity related to surgical incision as evidenced by
assessment of incision site.
Interventions-
* Assess the site of incision and the surrounding tissue.
* Assess any signs of edema and inflammation.
* Assess the discharge, the colour, amount of drainage.
* Elevation of head at 30-45°.
* Planning of diet rich in proteins, vitamins.
* Administration of antiseptics, as per order.
67. 4. Deficient knowledge about postoperative care as evidenced by
patient’s assessment of knowledge.
Interventions-
* Inform patient and family members about the expected effects and potential
side effects of medication.
* Instruct about aseptic measures during dressing.
* Avoid getting water in the operative ear for 2weeks after surgery.
* Any signs of increased drainage and inflammation should be immediately
brought into notice of the primary care giver.
* Follow up care.
68. 5.Risk for infection related to placement of grafts, prosthesis
secondary to ossiculoplasty.
Interventions-
* To monitor and record vital signs for every 2hrs.
* To perform hand hygiene while handling with patient.
* To maintain strict aseptic measures during dressing.
* To inspect the condition of wound.
* To observe for any signs of elevated temperature and purulent drainage.
* To maintain a clean environment.
* Administration of prophylactic antibiotics , as per order.
69. 6. Risk for injury related to vertigo due to dislodgment of prosthesis.
Interventions-
* Instruct patient to avoid heavy lifting, straining and nose blowing for 2-3weeks.
* Observe for any signs of difficulty in nerve injury such as – dropping of mouth,
slurred speech, decreased sensation and difficulty in swallowing.
* Administer antiemetics, as per order.
70. Prognosis
Death from AOM is rare in the era of modern medicine. With effective
antibiotic therapy, the systemic signs of fever and lethargy should begin to
dissipate, along with the localized pain, within 48 hours. Children with
fewer than 3 episodes are 3 times more likely to resolve with a single
course of antibiotics, as are children who develop AOM in nonwinter
months. Typically, patients eventually recover the conductive hearing loss
associated with AOM.