The tympanic membrane is bulging.

Full Answer Section

• Medications: "Are you currently taking any medications, including over-the-counter drugs?" This avoids potential interactions.

Teaching to Prevent Recurring Otitis Media:

• Reduce Exposure to Secondhand Smoke: Smoke irritates the Eustachian tube, increasing the risk of infection.
• Frequent Handwashing: Good hand hygiene helps prevent the spread of germs that can cause ear infections.
• Nasal Saline Drops: Regular use of saline drops can help clear congestion and prevent fluid buildup in the middle ear.
• Manage Allergies: Effectively managing allergies reduces inflammation in the Eustachian tube, lowering infection risk.
• Vaccinations: Ensure the child is up-to-date on vaccinations, especially pneumococcal conjugate (PCV) and influenza vaccines, which can help prevent ear infections caused by these bacteria and viruses.
• Proper Bottle Feeding: For infants, hold them upright while feeding and avoid prolonged bottle feeding while lying down, which can increase the risk of fluid entering the middle ear.
• Avoid Swimming with Ear Infection: Advise against swimming or submerging the head in water while the infection is present.

Expected Outcomes:

• Reduced Ear Pain: The child should experience significant improvement in ear pain within 2-3 days of starting treatment.
• No Fever: Any fever present should subside within a few days.
• Improved Hearing: Hearing difficulties should resolve as the infection clears.
• No Drainage: Ear drainage should cease within a week of treatment.
• Healthy Eardrum: Upon re-examination, the tympanometric membrane (eardrum) should appear normal, without bulging.
• Follow-up Appointment: Schedule a follow-up appointment in 7-10 days to assess progress and ensure the infection has resolved completely.

Note: This information is intended for educational purposes only and should not be interpreted as medical advice. Please consult with a qualified healthcare professional for diagnosis and treatment of any medical condition.

Sample Answer

Additional Questions for the 8-year-old girl:

• Severity of Pain: "On a scale of 1 to 10, how bad is your ear pain?" This helps gauge the severity of the infection.
• Ear Drainage: "Has any pus or fluid drained from your ear?" Drainage can indicate a ruptured eardrum.
• Hearing Changes: "Have you noticed any trouble hearing in your left ear?" Hearing loss can be a symptom of otitis media.
• Fever: "Do you have a fever or feel unusually warm?" Fever can be a sign of infection.
• Allergies: "Do you have any allergies, especially to medications?" This is important for selecting appropriate treatment.