An 8-year-old girl comes to your ambulatory care clinic

An 8-year-old girl comes to your ambulatory care clinic with complaints of left ear pain for the past 3 days. She had respiratory infection a week ago. On physical examination, the tympanic membrane is bulging.

Answer the following questions:

What else should you ask the client?
What teaching would you reinforce to prevent the recurrence of otitis media?
What expected outcomes would be specific to this situation?
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Here are some additional questions I would ask the client:

How would you rate your pain on a scale of 1 to 10?
Is the pain constant or does it come and go?
Is the pain worse when you swallow or move your head?
Have you had any fever or other symptoms of a cold or the flu?
Do you have any allergies?
Do you smoke or are you around smokers?
Have you had any ear infections in the past?

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Get plenty of rest when you are sick.
Drink plenty of fluids.
Use a humidifier in your home.
Avoid smoking and secondhand smoke.
Breastfeed your baby for at least 6 months.
Give your child a pacifier at night.
Make sure your child gets vaccinated against the flu and pneumococcal pneumonia.

Here are some expected outcomes that are specific to this situation:

The child’s pain will be relieved.
The child’s ear will be free of infection.
The child will not have any further ear infections.

Here are some additional things you can do to help the child:

Give the child over-the-counter pain relievers, such as ibuprofen or acetaminophen.
Apply a warm compress to the child’s ear.
Encourage the child to drink plenty of fluids.
Keep the child’s ear clean and dry.
If the child’s pain is severe or does not improve after a few days, take the child to see a doctor.