Otitis Media in Medical Surgical Nursing. It's includes definition ,types,causes,symptoms,dignosis,prevention,treatement,medication and nursing management.

1. OTITIS MEDIA
R. Priyadharshini Ramya B. sc ( N ) student
Kiran college of nursing Bangalore

2. DEFINITION :-
● An outer ear infection (otitis externa) causes
pain ,redness and swelling in your outer ear
canal .This is the tube that leads into your
ear . Outer ear infection is usually caused by
bacteria .But they may also be caused by a
fungal infection ,irritation or eczema in or
around your ear canal .

3. TYPES OF OUTER EAR INFECTIONS:-
An outer ear infection can last for a short time ( acute) or for a long time
(chronic).
1 .Acute outer ear infections come on suddenly. They usually go away
within six weeks, but the infection may then come back again.
2 .Chronic outer ear infections cause ongoing symptoms that may last for
several months or more. This can lead to permanent hearing loss.

4. CAUSES :-
1 .Damage to your ear canal
2 .Swimming
3 .Using hearing aids or earplugs
4 .Swimming in polluted water
5 .Living in a hot ,Humid climate
6 .Being sensitive to products like hair sprays and Hair dyes
7 .A build -up of earwax in your ear canal

5. PATHOPHYSIOLOGY :-
The external auditory canal is covered by hair follicles and cerumen - producing
glands .
cerumen provides a protective barrier and an acidic environment that inhibits
bacterial and fungal growth .
The inflammatory recaused response in otitis external is believed to be caused by
a disruption of the normal pH and protective factors within the auditory canal .
This includes a sequential process of damage to the epithelium , loss of
protective wax , and accumulation of moisture that leads to a higher pH and
bacterial growth .

6. SYMPTOMS :-
1 .A red or swollen ear canal
2 . Dry skin or eczema in or around your ear canal
3 .Pain (earache)
4 .Itching
5 .Discharge from your ear
6 .Temporarily dulled hearing

7. COMPLICATIONS :-
1 .Infections can spread across your skin (cellulitis)
2 .From a large collection of pus (an abscess)
3 .Malignant otitis externa (sever infection called
necrotising )

8. DIAGNOSIS :-
1 .Gram stain and culture of any discharge from the auditory canal
2 .Blood glucose level
3 .Urine dipstick
4 .High - resolution computed tomography (CT )
5 .Radio nucleotide bone scanning
6 .Gallium scanning
7 .Magnetic resonance imaging ( MRI )

9. PREVENTION :-
● Dry your ears with a dry towel or hair dryer . Don’t use cotton or other
objects to clean your ear canal .
● If you use ear plugs when you go swimming .Use ear plugs when you go
swimming .
● Always tips out any water from your ears after swimming or having bath
or shower .
● Use acidic drops from your pharmacist before or after swimming .
● Avoid washing your ears with soap as this spoils the natural acidity of
your ear canal .
● Don’t swim in polluted water .

10. TREATMENT :-
● Pain management
● Removal of debris from the EAC
● Administration of topical medication to control
edema and infection
● Avoidance of contributing factors

11. PHARMACOTHERAPY :-
● Topical medication (e.g , acetic acid in aluminum acetate ,hydrocortisone
and acetic acid otic solution , alcohol vinegar otic mix )
● Analgesic agent ( e.g ,acetaminophen , acetaminophen and codeine )
● Antibiotics (e.g hydrocortisone /neomycin ,otic ofloxacin,otic
ciprofloxacin , otic finafloxacin ,gentamicin 0.3%/prednisolone1%
ophthalmic
● Oral antibiotic (e.g ciprofloxacin )
● Antifungal agents (e.g otic clotrimazole 1%solution ,nystatin powder )

12. SURGERY :-
● Surgical debridement of the ear canal
● Incision and drainage of an abscess

13. NURSING MANGEMENT:-
● Assess client ‘s description and frequency of pain ;use a pain rating scale .
● Rub the affected ear ,roll the head and appear irritable .
● Monitor the vitals closely
● Encourage and assist the parents to hold and comfort the client .
● Encourage the liquid to soft food .
● Administer the pain medication such as acetaminophen or ibuprofen alter response to
pain .
● Monitor child for relief of pain and any side effect of medication .
● Monitor the advers effect of the medication .
● Have the child situp , put pillows behaind the head , or lie on the unaffected ear .