Ear infections are common among babies from 3 months to 3 years; 5 out of 6 children have this infection at least once. Ear infections in babies are called acute otitis media and are a disease of the middle part of the ear. Ear infections can be caused by virus infections (such as flu) or bacterial infections. As a result of a disease, the middle ear becomes inflamed, which can be seen as redness, and fluid can accumulate in the middle ear. Sometimes euchastian tubes also show signs of infection. Babies are more prone to ear infections because their ear canals are shorter than adults and are more horizontal. Babies are more likely to get colds, and viral infections, which increase the risk of ear infections, and their immune systems are less developed than adults.
Common sign / symptoms
Fussiness due to discomfort and pain, trouble sleeping or lying down flat, pulling at the ear from pain, fever between 100 and 104 F, decreased appetite due to fever, pain, and discomfort while swallowing and suckling, digestive discomfort, clumsiness due to ear balance issues, yellow or brownish fluid running from ear, difficulty hearing.
Potential complications may be serious for babies: fluid buildup can cause temporary hearing loss. If left untreated, the disease can cause irreversible hearing problems in a child due to a ruptured eardrum under pressure from fluid accumulated behind the eardrum; as a result, the child will have problems with speech. Ear infections are treated very quickly with antibiotics. If the ear is re-infected, excess tissue may form behind the eardrum, which will need to be removed surgically. In very rare cases, ear infections can cause meningitis.
Expected assessment findings
Redness and inflammation in the middle ear, accumulation of fluid in the middle ear (a red, bulging eardrum).
Diagnostic studies / labs
Assessment is held using an otoscope, pneumatic otoscope, and tympanometry. The otoscope is used to look into the ear and see the eardrum abnormalities: a bulging red eardrum indicates infection. A pneumatic otoscope is used to check for fluid behind the eardrum (a normal eardrum moves back and forth more easily than an eardrum with fluid behind it). Tympanometer is used to measure the pressure in the baby’s ear; it measures how flexible the eardrum is to different pressures.
Normal values: no redness and inflammation, flat and more easily moving eardrum.
Expected abnormalities: red bulging eardrum; obstructed moving eardrum due to fluid behind it.
All NANDA Nursing Diagnoses
NANDA Nursing Diagnoses approved for 2018-2020 has 13 domains which include 89 diagnoses. The domains are Health promotion, Nutrition, Elimination and exchange, Activity/Rest, Perception/cognition, Self-perception, Role relationship, Sexuality, Coping/stress tolerance, Life principles, Safety/protection, Comfort, Growth/development.
Ricci, Susan S., et al. Maternity and pediatric nursing. 2ed., Lippincott Williams & Wilkins, 2012.