# A nurse is caring for a 6-year-old child diagnosed with acute otitis media. Which nursing intervention should be the priority?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=541684  
> language: ko  
> subject: Child Health

## 문제

A nurse is caring for a 6-year-old child diagnosed with acute otitis media. Which nursing intervention should be the priority?

## 보기

1. Irrigate the ear canal with warm saline solution
2. Administer prescribed analgesics and antibiotics as ordered **✔ 정답**
3. Apply cold compresses to the affected ear
4. Perform otoscopic examination to assess tympanic membrane

**정답: 2**

## 해설

Priority nursing intervention for acute otitis media is administering prescribed analgesics and antibiotics to manage pain and control infection. Other options like ear irrigation or cold compresses are not recommended due to risk of complications.

## 심화 해설

Understanding Acute Otitis Media

Acute otitis media (AOM) is an infection of the middle ear characterized by the rapid onset of signs and symptoms of inflammation. As noted in the foundational review, the hallmark is middle ear effusion accompanied by acute illness indicators such as ear pain (otalgia), fever, irritability, and ear tugging [1]. In a 6-year-old child, the eustachian tube is still relatively horizontal and short, making it easier for pathogens from the nasopharynx to ascend and cause infection. This anatomical predisposition explains why AOM is the second most common pediatric diagnosis in emergency departments [1].

Rationale for the Priority Intervention

The correct priority is to administer prescribed analgesics and antibiotics as ordered. The primary concerns in the acute phase of AOM are pain management and eradication of the bacterial infection. The intense ear pain stems from the pressure of purulent fluid accumulating against the inflamed, highly sensitive tympanic membrane. Administering an analgesic directly addresses this immediate discomfort, which is the patient's most pressing need. Concurrently, initiating antibiotic therapy targets the underlying bacterial pathogens, preventing potential complications such as tympanic membrane perforation or progression to chronic suppurative otitis media [1].

Analysis of Incorrect Options

- Option 1 (Irrigate the ear canal): This is contraindicated in AOM. Irrigation is only considered for external ear debris or cerumen impaction. If a tympanic membrane perforation is present—a clinically significant subset of AOM that results in otorrhea [1][2]—flushing the canal could introduce pathogens deeper into the middle ear space, worsening the infection or causing vertigo.

- Option 3 (Apply cold compresses): While a cold compress might provide minimal, temporary comfort, it is a supportive measure, not a priority intervention. It does not address the severe pain at its source or the infectious process. Pharmacological pain relief is the standard of care.

- Option 4 (Perform otoscopic examination): Assessment is a critical nursing role, but the question asks for a priority intervention. By the time a diagnosis of AOM is made, an otoscopic examination has already been performed by a provider to visualize the bulging, erythematous, or opaque tympanic membrane. The nurse's priority now shifts from assessment to implementing the treatment plan to relieve pain and combat infection.References (research sources)

- [1]Acute Otitis MediaResearch articleMatz O, Sutton AE, Ashurst JV. (2026)

- [2]Management of acute otitis media with otorrhea in Italian pediatric practice: a national survey.Research articleMarchisio P, Miraglia Del Giudice M, d'Avino A, Zampogna S, Ciprandi G, Marseglia G. (2026) · DOI: 10.1186/s13052-026-02286-7

## 임상 시나리오

Pediatric AOM: Pain & Infection ControlPrioritize comfort and treat the source
For a child with acute otitis media, the immediate priority is dual: relieve intense ear pain and eradicate the infection. Administer prescribed pain relievers (e.g., acetaminophen, ibuprofen) and the first dose of antibiotics without delay.

Pain stems from purulent fluid pressing against the inflamed eardrum. Analgesics are not just for comfort—they are a core intervention. Untreated pain in children can lead to significant distress and physiological stress.

CautionNever irrigate the ear canal in suspected AOM. This can cause eardrum rupture if perforation is present. Reserve irrigation for external ear debris only.

## 핵심 개념

- **Acute Otitis Media (AOM)** — A rapid-onset infection of the middle ear marked by middle ear effusion and signs of inflammation such as otalgia, fever, and irritability.
- **Otalgia** — Ear pain, the primary symptom in AOM caused by purulent fluid pressure against the inflamed tympanic membrane.
- **Eustachian Tube** — The canal connecting the middle ear to the nasopharynx; in children, it is shorter and more horizontal, increasing infection risk.
- **Priority Intervention** — The nursing action that addresses the most immediate life threat or patient need, in this case, severe pain and infection control.
- **Tympanic Membrane** — The eardrum, which becomes inflamed and bulging in AOM, causing intense pain.

## 같은 주제 문제

- [A nurse is assessing a 35-year-old patient who presents to the emergency department with c…](https://mymerci.kr/pages/nclex_q.php?qn_id=541681)
- [A nurse is assessing a 45-year-old client who reports ear pain and hearing loss. Which ass…](https://mymerci.kr/pages/nclex_q.php?qn_id=541682)
- [A nurse is caring for a 6-year-old child diagnosed with acute otitis media. Which nursing …](https://mymerci.kr/pages/nclex_q.php?qn_id=541683)
- [A nurse is assessing a 2-year-old child with suspected acute otitis media. Which assessmen…](https://mymerci.kr/pages/nclex_q.php?qn_id=542571)
- [A 6-month-old infant is brought to the emergency department by parents who report the chil…](https://mymerci.kr/pages/nclex_q.php?qn_id=542572)
- [A 2-year-old child is brought to the emergency department by parents who report the child …](https://mymerci.kr/pages/nclex_q.php?qn_id=542573)
- [A 4-year-old child with acute otitis media is prescribed amoxicillin. The parents ask the …](https://mymerci.kr/pages/nclex_q.php?qn_id=542574)
- [A 2-year-old toddler with acute otitis media is prescribed amoxicillin. The parent asks th…](https://mymerci.kr/pages/nclex_q.php?qn_id=542575)

---

More free questions: [기출문제](https://mymerci.kr/)

_학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._