Otitis Media: Nursing Diagnosis

Nursing Knowledge

Otitis Media: Nursing Diagnosis

Otitis media (inflammation/infection of the middle ear) is a common condition that is prevalent in both children and adults and can lead to complications, if left untreated. As a nurse, understanding the symptoms, causes, and treatment options for otitis media is essential in providing appropriate care to clients. Keep reading for an overview of otitis media, including its symptoms, causes, risk factors, and complications.

Last updated: December 15, 2025

What is otitis media?

Otitis media is the inflammation or infection (viral or bacterial) of the middle ear. It affects 10% of people globally each year; 50% of cases occur in children.

What causes otitis media?

Otitis media can be caused by bacterial or viral infection, or allergic reactions. Risk factors are:

Exposure to:
- Secondhand smoke
- Allergens
- Large groups of people
Pacifier use
Craniofacial abnormalities

What are the symptoms of otitis media in children and adults?

Symptoms in adults:

Irritability
Fatigue
Loss of balance
Fever
Otalgia (ear pain)
Difficulty hearing

Symptoms in children:

Irritability
Tugging at the ear
Loss of balance
Fever
Otalgia (ear pain)
Difficulty hearing

Nursing diagnosis for otitis media

The possible nursing diagnoses for otitis media can differ for adults and children.

Nursing diagnoses for otitis media may include:

Acute pain related to inflammation and increased pressure from fluid accumulation in the middle ear
Impaired verbal communication due to the pain or hearing impairment
Disturbed sleep pattern related to pain and discomfort
Anxiety related to the illness, especially if there are repeated episodes

In children, some additional nursing diagnoses could include:

Acute pain may manifest differently in children who may not be able to articulate their discomfort: They may show signs of irritability, changes in eating habits, or pull at the affected ear.
Ineffective coping as the child may exhibit behavioral changes due to the discomfort or pain associated with otitis media.
Risk for delayed development: If otitis media is chronic or recurrent, it could potentially impact language acquisition and cognitive development due to impaired hearing.

Potential complications of otitis media

Potential complications include:

Perforation of the tympanic membrane
Speech or hearing delays or challenges
Mastoiditis: infection of the mastoid space behind the ear
Rarely: brain infections

What is the Eustachian tube and how does it differ in infants and adults?

The Eustachian tube is a tube that connects the middle ear to the back of the throat.

	Adults	Infants
Length	Approx. 18 mm	Approx. 9 mm
Direction of drainage into throat	More vertical, assisted by gravity	Horizontal

Table: Eustachian tube in adults vs infants

How to treat otitis media

OTC analgesics (NSAIDs or acetaminophen)
Antibiotics if caused by a bacterial infection
Decongestants
Antihistamines
Tympanostomy tubes for recurrent cases
Rest

Nursing interventions for otitis media in children

Pain management; promote comfort and rest
Administer antibiotics as ordered
Monitor vital signs (temperature!), pain levels, behavior changes
Educate parents/caregivers about signs of complications and preventive measures
Tympanostomy tubes for recurrent cases

How to Administer Ear Drops

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