Nursing diagnosis for ear infection

  1. 0
    Child is suspected of having an ear infection as evidenced by reddened, inflamed, bulging, tympanic membrane. Child can only sleep for up an hour at a time with out waking up and complaining of ear pain. What nursing diagnosis is used?

    A lot of students are putting Acute pain r/t inner ear infection. I was looking all over in my books for that diagnosis, or more specifically Acute Pain. I could not find it, I was under the impression acute pain is an actual medical diagnoses and something that is "beyond" the nurses scope of practice. Any thoughts? What diagnosis would you use and why?
  2. 9 Comments so far...

  3. 1
    Acute Pain is a NANDA diagnosis. Here's the 2007-2008 list.

    http://wps.prenhall.com/wps/media/ob...74686_AppC.pdf
    Idaho Murse likes this.
  4. 1
    a child who cannot sleep for more than a half hour would have a lot more problems than pain... ineffective coping skills (waaay more temper tantrums and break downs due to lack of sleep), regressed behaviors (children often get very uncoordinated and have trouble with newly learned activities when they have pain and exhaustion issues, not to mention the affect of ear problems on equilibrium/vertigo). Dont have time to look up all of the diagnoses but hope that helps. My daughter just had a tympanectomy for recurrent ear infections less than a month ago, and my 14 yr old son had them as well when he was small. (not suprisingly to me, those are the 2 of my 3 children that did not get breastfed/or I stopped breastfeeding early... but I will avoid my soapbox )
    Idaho Murse likes this.
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    Although I agree that ineffective coping is applicable, I feel it would not be the primary nursing diagnosis. I would go with the problem that needs immediate intervention: acute pain. Acute pain is an approved NANDA DX. It should be in all current care plan books. If you have any texts that use the Evolve website, set up an account and add the Gulanick/Myers Nursing Care Plan book to your list of resources.
    Idaho Murse likes this.
  6. 1
    I would also go with Acute Pain as my primary nursing diagnosis - yes, the others would apply, but would not be the first in order of importance.

    I would probably say something like Acute Pain: R/T inner ear infection; AEB reddened, inflamed. bulging tympanic membrane.

    Just be cautious, some of our instructors would not let us use the words "inner ear infection" because that is a medical diagnosis and they are sticklers for not having anything that is a medical diagnosis in the R/T. Others don't care...just know what your instructor allows.
    Idaho Murse likes this.
  7. 1
    What about risk for injury related to the complication of infection.
    Idaho Murse likes this.
  8. 1
    I think that risk for injury would also apply. However, if you are creating a prioritized list, acute pain would probably be at the top.

    In most scenarios, you want to go with your ABC's first, then move on from there with pain being at the top. I don't think that in this scenario the ABC's apply.

    Risk for injury R/T impaired balance maybe....complication of infection may be too vague for some instructors.
    Idaho Murse likes this.
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    WELL the OP doesnt say "primary" anything, and if she wants to just do the primary, she can just copy off of her classmates

    Obviously anything related to coping difficulties comes before pain management on maslow's hierarchy but that doesnt negate the diagnosis... If the entire class is doing the same case, which is what I interpreted it to be, I would imagine the teacher would be looking for critical thinking skills, not just the result of a group of students agreeing on one diagnosis. My teachers generally want ALL of as many nursing diagnoses as we can come up with, not just the single primary...

    But whatever~ If you want to say 'kudos' and whatever to commentary negating my input, then I just wont give it. lol Its all good
  10. 0
    I'm not trying to negate anything and no where did I indicate that this was a solitary diagnosis - I said "if you are creating a prioritized list...", use of the word LIST would indicate more than one. We are also required to list any and all nursing diagnoses for each patient, but they must be in a prioritized order.

    Based on what we have been doing, we would treat the acute pain as the top priority because risk for injury or risk for ineffective coping would be manifested based on lack of sleep which is due to the pain, therefore treating the pain first would assist in alleviating the other issues. Perhaps we are interpreting maslow differently, because I would interpret pain as being a physiological need which would be met first and foremost....it could be a difference in teachings at our schools, this is only my interpretation based on the courses that I am taking - that's why it is good to get input from more than one person.

    I was in no way trying to negate anything that you said, all of your points were valid and important to make.
    Last edit by sh1901 on Mar 24, '09
  11. 0
    the first thing to do with a medical diagnosis is break it down into its signs and symptoms. nursing diagnoses are based upon the patient's responses to their medical problem. medical diagnoses are of little use to us in putting together a care plan (determining nursing problems) without breaking the medical diagnosis down into its signs and symptoms.


    pain is not the only symptom of an ear infection. as someone who had many ear infections as a child i can tell you that hearing acuity is also affected because the ear canal and internal structures become swollen. pain is acute. inflammation accompanies all infections. the 4 cardinal signs of inflammation are redness, heat, swelling and pain. the kids health website is a good place to go for pediatric information: http://kidshealth.org/parent/infecti...tis_media.html (ear infection).
    • for pain, use acute pain r/t inflammation of ear
    • other possible diagnoses that would apply based on symptoms"
      • (risk for) nausea r/t inflammation of labyrinth of ear
      • hyperthermia r/t inflamed ear
      • disturbed sensory perception, auditory r/t altered sensory reception secondary to inflammatory response
      • risk for deficient fluid volume r/t nausea and vomiting
      • risk for injury r/t dizziness


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