The nurse administer ear drop to a 7 -year-old child. How does the nurse pull the patient's ear?

Appeared in: Chitranjjan National Cancer Institute Kolkata - 2021

Explanation

For a 7-year-old child, the correct procedure is to pull the pinna upward and backward.
This action is necessary because, in children aged 3 and older, the external auditory canal has an S-shape, similar to that of an adult.
Pulling the ear up and back straightens the canal, ensuring that the medication can travel effectively to the tympanic membrane.
This technique maximizes the therapeutic effect of the ear drops.

Option A: Pulling the pinna 'Outward' is not a standard nursing procedure for administering ear drops and does not effectively straighten the auditory canal for medication instillation.
Option B: Pulling the pinna 'Backward' alone is an incomplete action. It fails to straighten the S-shaped curve of the ear canal in a 7-year-old, which is necessary for the medication to reach the eardrum.
Option D: Pulling the pinna 'Backward and Downward' is the correct technique for infants and children younger than 3 years of age, not for a 7-year-old.

Clinical Relevance

Nursing practice connection: Use the key finding related to Procedure for Administering Otic Medications in Children to guide bedside assessment, documentation, and the next nursing action.
Using the correct technique for ear drop administration is crucial for medication efficacy. An incorrect procedure can lead to the medication pooling in the outer ear canal and failing to reach the intended site of action.
Patient comfort and safety are enhanced by using the proper technique, which minimizes discomfort and ensures the medication is delivered correctly.
What if? If the child were 2 years old instead of 7, the correct procedure would be to pull the pinna 'Backward and Downward' because the anatomy of the ear canal is different in children under 3.

How to Approach the Question

First, identify the key information in the question: the procedure (administering ear drops) and the patient's age (7 years old).
Recall the anatomical differences in the ear canal based on age. Remember the cutoff age is 3 years.
For children 3 years and older, the procedure is the same as for adults.
For children under 3 years, a different technique is used.
Select the option that describes the correct technique for a child older than 3 years, which is pulling the pinna upward and backward.

Concept Tested & Keywords

Concept Tested: Procedure for Administering Otic Medications in Children
Stem keywords: ear drop, 7-year-old child, pull the patient's ear
Lead-in keywords: How
Clinical cues: Patient age (7 years) is the critical factor determining the correct procedure.

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E6 Pharmacology Nursing Lilley 11e Part 1 p. 146-148

E6 Nursing Fundamentals Taylor p. 867-869

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