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Ni Ketut Alit A

Nursing Faculty Airlangga University


Surabaya East Java.

Black, J.M. & Matassarin E, (1997). Medical Surgical Nursing:


Clinical Management for continuity of care. J.B. Lippincott.co.

Barbara C.L & Wilma J.P. (2006). Essentials of Medical Surgical


Nursing. Philadelphia: Lippincott Williams & Wilkins.

Smeltzer, S.C., & Bare, B. (2003). Brunner and Suddarth's


Textbook of Medical-Surgical Nursing (10 th ed.). Philadelphia:
Lippincott Williams & Wilkins.

Ignativicius & Bayne. (2001). Medical and Surgical Nursing.


Philadelphia: W.B. Saunders Company.

Luckman & Sorensen. (2000). Medical Surgical Nursing.


Philadelphia: W.B. Saunders Company.

Journals and article related to..

The epithelial lining of the middle ear


<continous>
The epithelial lining of the mastoid air cells
(Embedded in the temporal bone)
Mastoiditis is a secondary disorder resulting
inadequated treated Otitis Media.
Mastoiditis can be either acute or chornic; it
was leading cause of death in children and
hearing lossmin adults

The clinical manifestations


of mastoiditis include:

Swelling behind the ear


Pain with minimal movement of tragus,
the pinna, or the head.
Cellulitis develops on the skin or external scalp
over mastoid process
Clients withs mastoiditis also have low grade
fever, malaise, and anoreksia

Reveals :
a red, dull, thick, immobile tympanic
membrane with or without perforation
Postauricuar lymph nodes are tender and
enlarge.

Non Surgical management:


Antibotic therapy is aimed at preventing the
continued spread of infection from the
otitis media or mastoiditis.
But it has limited
use in the actual
treatment of mastoiditis because of the
difficulty of acchieving effective antibiotic
levels within the bony structure of mastoid.
Culture material is obtained from the ear
drainage or by myringotomy.

Surgical removal of the infected tissue is


necessary if the client does not respond to
antibiotic administrationwithin a few day.

A
simple
or
modified
radical
mastoidectomy with tympanoplasty is the
most common treatment.

All infected tissue must be removed so


that the infection doesnot spread to other
structures.

Reassures the client that operative will


relive pain
Discusses the reason for the prosedure with
the client and relieve anciety
Cleans the exteral canal with a
bacteriostatic solution

Avoid straining when you have bowel elimination.


Do not drink through a straw for 2-3 wk
Avoid air travel for 2-3 wk
Stay away from people with cold
Avoid getting your head wet, washing hair,and
showering for 1 wk
Keep yor ear dry for 6 wk by placing a ball cotton
change daily
Avoid rapidly moving the head for 3 wk
Change eardressing every 24 hour
Report excessive drainage

Compication arise :
Infective material has not been removed
completely.
Contamination of other structure outside
the mastoid and middle ear.
Complication include :
Damage to the abducens (NC VI) and facial
cranial nerves (NC VII)
Decreasing ability to look laterally
Dropoping the mouth on the affected side

Vertigo
Meningitis
Brain abcess
Chronic purulent otitis media
Wound infection

Early manifestation of mastoiditis


development

PSYCHOSOCIAL ASSESMENT
Fear of losing hearing
Deny that the change occurred

Pain
Sensory /perceptual alteration (auditory)
Risk of infection
Hipertermi
Anciety

Write down education guide for client post


surgery with mastoiditis!!

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