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Question:
A 2-year-old presents to the urgent care clinic for cerumen impaction. The nurse is instructed to perform an ear irrigation. Which interventions should the nurse take?
A. Position the child with affected ear facing upward.
B. Cleanse the external ear and external canal to clear any visible debris.
C. Use a cotton-tip applicator to clean the internal canal as much as possible prior to the irrigation.
D. Pull the tragus downward and backward, insert syringe, and direct the solution toward the top of the ear.
E. Pull the pinna downward and backward, and insert the syringe to direct the flow of solution toward the top of the ear.
A
A, B, and E
explanation
To properly perform an ear irrigation on a child less than 3 years of age, the nurse should position the child in a comfortable position with affected ear upward, any visible debris should be removed from the external ear canal and external ear, and the pinna should be pulled gently downward and backward to straighten the ear canal prior to inserting the syringe and inserting the fluid. Cotton-tip applicators should not be inserted into the internal ear or ear canal. The tragus is not manipulated or positioned during an ear irrigation.
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