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Asked by markangel21

Read the scenario below and Describe how this new knowledge could impact your nursing practice.

 

 

 

 

Clinical Scenario

3 y/o male presents to the ED with ear pain, temp 38.5 C (101 F), and fussiness.

 

External and Internal Cues

Congestion

Runny nose

Low grade fever

Irritability

Grimacing upon inspection of the affected ear

 

Hypotheses

Otitis media- left untreated, otitis media can lead to perforation of the tympanic membrane, febrile seizures related to elevated body temperature, meningitis, epidural abscess, and permanent loss of hearing. Otitis media is extremely common in young children because of the developmental alterations in the eustachian tubes. This is the most likely diagnosis.
Foreign object inside the ear- can lead to pain, infection, and hearing loss.
Impacted earwax

 

Generate Solutions

Otitis media: Identify and treat causative agent and relieve pain
administer antibiotics
administer pain medication and antipyretics
Foreign object
removal of the foreign object
pain relief prior to procedure

 

Take Action

Due to the child’s age, it is important to provide comfort and relieve the any anxiety the child may be experiencing. In this particular case, the patient’s onset of symptoms began after a day of swimming. There were no diagnostic tests performed, he was treated based on the subjective and objective data collected.

 

Evaluate Outcomes

Patient was prescribed acetaminophen to relieve pain and fever. Patient was also sent home on a regimen of antibiotics (amoxicillin) for 1 week.

Summary of the ongoing iterative process of Clinical Judgment

The provider (and nurses) suspected otitis media upon admittance to the ED. Because of the symptoms and pain present, the provider decided not to do an internal ear inspection and assessment. I feel that this was appropriate due to the incidence of ear infections in young children. Once the toddler became comfortable with the healthcare staff, he took his medication without complications and was then given a treat. The parent was instructed to follow up with the primary care pediatrician the following day. During this interaction, I was able to watch how the nurses interacted with a young child, and gained his trust and cooperation, which is not always an easy task.

SCIENCE
HEALTH SCIENCE
NURSING
NUR 4153

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