Running&head:&CHILD&EAR&INTERVENTIONS&&&

&

An Ear Assessment and its Interventions

Natasha English
N01036279
Humber College
NURS104
John Stone
October 29th, 2014

1&

CHILD&EAR&INTERVENTIONS&&
&

&

2&

Introduction
Illness in a child can result in many issues both short and long term. Unaddressed these
can manifest into issues that will affect ones quality of life. There are many non-medical
interventions which can be followed to minimize any lasting effects. A child visited my clinic
and due to the information presented at the time of the visit to the clinic and the information
provided by the parents, there are two priority areas that I feel need to be addressed in relation to
the ear assessment. The two areas that are to be examined are minimizing future risk of illness
and the childs hearing ability. Within those areas are six interventions that I feel would greatly
benefit the child.
Patient Information
The first type of data presented by the client is the objective data. The child who has been
brought into the clinic is an 18 month old male who weighs 36 lbs. When examining past history
it was determined that the child had ongoing issues with illness and was prescribed antibiotics
for several months, a few times during each of those months. His medical history also states that
all his immunizations are up to date. The next type of data examined was the subjective data.
Unfortunately since the child is not yet talking, it is unknown if he is experiencing any pain and
the parents did not indicate theyve seen any signs of this. The parents noticed that occasionally
when they went to the childs bed they would find stains on his blanket, which are either amber
or red tinged. The child is not yet walking and does not speak other than saying mama or
dada on occasion. Theyve also indicated that the child appears to be stubborn because when
they speak to him he often does not respond unless he is looking at them.
Priority Area Future Illness
The first priority area to be addressed is the history of illness. The child experienced this
illness several times for several months and had to take medication three different times in each

CHILD&EAR&INTERVENTIONS&&
&

&

3&

of those month. It seems as though there could be an issue with ear infections or this illness
could lead to an increased risk of ear infections so it is important to minimize risk of future
occurrences. This is because progressive hearing loss can be caused by repeated ear infections
(Jarvis, Browne, MacDonald-Jenkins, Luctkar-Flude, 2014). Without taking steps to minimize
the risk, other efforts to resolve the childs health problem could be negated. There are several
interventions that can be put in place. Another reason why I feel this is important is because the
more antibiotics that are given to a child the more likely it is that the antibiotics will fail. By
reducing the risk factors, it can minimize the chance of getting an infection, which in turn
reduces the amount of antibiotics the child will be exposed to (Kalyanakrishnan, Sparks,
Berryhill, 2007).
Future Illness - Interventions
The first intervention is to address the way the child consumes fluids. Currently the child
is provided with a bottle. According to Jarvis et al., (2014) the use of a bottle has been known to
create more problems with ear infections. In order to change this the parents should discontinue
use of the bottle. A suggestion would be to teach the child to use a regular cup, a cup with a
straw, or a sippy cup designed for toddlers. If the child is having a difficult time with immediate
removal, suggest that the parents make a gradual change, first eliminating any times where the
child may be in a supine position with the bottle, as being in the supine position can cause an
even greater risk (cite). The second intervention is to educate the parents on other environmental
factors that could increase the risk of infections. These factors include pacifiers, second hand
smoke, exposure to cold, and loud environments (Jarvis et al., 2014). By educating them on these
factors they can either change or remove them, or avoid environments where these may be an
issue. My third intervention would be to suggest allergy testing. Specifically looking for an
allergy to cows milk because it has been shown that this specific allergy can increase the risk of

CHILD&EAR&INTERVENTIONS&&
&

&

4&

ear infection (Juntti, Tikkanen, Kokkonen, Alho, Niinimaki, 1999). If the testing did come back
to show an allergy to this kind of milk, the parents could omit this from the childs diet and
introduce a milk alternative.
Priority Area - Hearing
According to Jarvis et al., (2014) there are several signs that a child may be experiencing
hearing loss. These include the child being more interested in movement and expressions on
peoples faces than sounds, speech is affected and the child may just make sounds or have
garbled speech, and the child is not interested in conversations around him or her. The child in
this case presents with all of these signs, as his parents report him to be stubborn when they are
speaking to him unless he is looking at them and he is lacking speech other than saying the same
two words infrequently. Based on the symptoms that the child shows (not responding to sound,
only responding if looking at a person, and not speaking), it appears that the childs hearing has
possibly been affected. I believe that this is an important priority area because not only is hearing
important to maintain a normal life, it can affect the development of other areas. In order to
speak properly, hearing must be functional. It has been shown that children who experience
hearing loss achieve lower scores on speech tests. Hearing loss can also affect cognitive and
language abilities (Kalyanakrishnan et al., 2007). The interventions in this area are long term
goals as they are achieved over time and must be met with commitment and hard work (Potter et
al., 2014).
Hearing - Interventions
Based on this priority area Ive come up with three different interventions. The first
intervention would be to perform hearing assessments at scheduled intervals by an audiologist.
By performing hearing assessments the childs hearing ability would be able to be monitored and
will allow for adjustments in the overall intervention as needed. It is important to understand

CHILD&EAR&INTERVENTIONS&&
&

&

5&

how the child is doing so he can be provided with the appropriate services and information. The
second intervention is to have the child engage in speech therapy. Speech therapy will allow a
therapist to work with him on developing age appropriate language skills so he does not fall even
further behind in his development. The last intervention would be for the parents to attend
classes that provide support on how to interact and communicate with a child who appears to
have hearing loss. This would promote greater communication between the child and the parents,
as well as family, friends, and the community. The parents would have support on how to
address any issues that arise.
Conclusion
Addressing the issues of hearing and future infections is extremely important. I believe
that hearing is an extremely critical part of normal life. Since it affects other areas as well, its
important to address and provide interventions. Its also important to provide ways to minimize
future illness because the progression of hearing interventions can be disrupted with
reoccurrences of these illnesses. I believe with the appropriate interventions the future of this
child is more likely to be a healthy one with little ear complications.

CHILD&EAR&INTERVENTIONS&&
&

&

6&

Resources
Jarvis, Carolyn, Annette Browne, June MacDonald-Jenkins, Marian Luctkar-Flude. Physical
Examination and Health Assessment, Canadian Edition, 2nd Edition. Saunders Canada,
2014.
Juntti, H., Tikkanen, S., Kokkonen, J., Alho, O-P., Niinimaki, A. (1999). Cows milk allergy is
associated with recurrent otitis media during childhood. Oto-Laryngologica, 119, 867873.
Kalyanakrishnan, R., Sparks, R., Berryhill, W. (2007). Diagnosis and treatment of otitis media.
American Family Physician, 76(11), 1650-1658.
Potter, P., Perry, A., Ross-Kerr, J., Wood, M., Astle, B., Duggleby, W., Canadian Fundamentals
of Nursing, 5th Edition. Mosby Canada, 2014.

The citation provided is a guideline. Please check each citation for accuracy before use.