Primary Nursing Diagnosis

Risk for infection related to invasion or proliferation of microorganisms

OUTCOMES. Immune status; Knowledge: Infection control; Risk control; Risk detection; Nutritional status

INTERVENTIONS. Medication administration; Medication management; Surveillance; Teaching: Disease process


Once AOM is diagnosed, the primary treatment is pharmacologic. However, a current debate exists as to whether antibiotics are appropriate because of growing rates of antibiotic-resistant bacteria. Many physicians support the idea that because 60% to 90% of the infections resolve without antibiotics, treatment for all AOM may not be necessary. Antibiotics are recommended for children with clear local signs (bulging membrane with cloudy or yellow fluid, very red membrane, or otorrhea), if systemic signs (fever in particular) are present, if more than three attacks have occurred in the past 18 months, or if OME is present. Decongestants and antihista-mines are not considered helpful unless the child has allergies.

In patients with severe pain, therapeutic drainage (myringotomy) may be necessary to provide immediate relief. An incision is made that is large enough to allow for adequate drainage of the middle ear. Children who undergo this procedure need to be evaluated after approximately 14 days to determine that the infection and otoscopic signs are resolving.



0 0

Post a comment