Question

A myringotomy is performed on a client in the ambulatory care center. The ambulatory care nurse calls the client 24 hours after the procedure to evaluate the status of the client. The client reports to the nurse that a small amount of brownish drainage has been coming from the ear. Which instruction should the nurse provide to the client?

Option 1: "This is expected, continue to observe for any changes."
Option 2: "Notify the doctor immediately; this may indicate an infection."
Option 3: "Apply a warm compress to the ear to stop the drainage."
Option 4: "Place cotton balls in the ear to absorb the drainage."

Answer 1

After a myringotomy, some drainage is expected. The correct advice for the nurse to give would be to continue to observe for any changes and to be vigilant for signs of infection. Immediate contact with a doctor is not necessary unless there are changes that suggest an infection.

Step-by-step explanation:

A myringotomy is a surgical procedure done to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear. After the procedure, if a client reports a small amount of brownish drainage, the nurse should consider whether this is typical post-operative drainage or a sign of infection. It is not unusual to have some drainage after a myringotomy, especially if there was an accumulation of pus due to acute otitis media (AOM) or otitis media with effusion (OME). However, the nurse should also be on the lookout for signs of infection, which can include an increase in the amount of drainage, a change to a yellow-green color, foul smell, and fever.

Given this, the most appropriate instruction for the nurse to provide to the client would be Option 1: "This is expected, continue to observe for any changes." The client should be advised to monitor the drainage and to report any changes in color, amount, or the onset of additional symptoms like fever or increased pain which could indicate an infection. Applying a warm compress (Option 3) or placing cotton balls in the ear (Option 4) is not necessary unless instructed by a physician for specific symptoms or discomfort. Notifying the doctor immediately (Option 2) may be premature without additional signs of infection, but the client should be aware of what to look for and when it becomes necessary to contact healthcare services.