A 1-year-old child who goes to day care is recovering from an episode of otitis media. Which intervention is most important for the nurse to recommend to the parents in order to prevent recurrence?

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11ecbb05_caf6_b929_b433_616459246283_MD0009_00 Otitis media (OM) is the inflammation or infection of the middle ear resulting from dysfunction of the eustachian tube. OM typically occurs in infants and children under age 2, sometimes following a respiratory tract infection. The eustachian tubes in infants and young children are short, straight, and fairly horizontal, which results in ineffective drainage and protection from respiratory secretions. Infants with exposure to tobacco smoke are at risk for OM due to the resulting respiratory inflammation. OM risk is also higher with activities such as using a pacifier or drinking from a bottle when lying down as these allow fluid to pool in the mouth and then reach the eustachian tubes. Key preventive measures include eliminating exposure to smoke, obtaining routine immunizations to prevent infection, and reducing or eliminating use of a pacifier after age 6 months. (Option A) Breast-fed infants have a decreased risk for OM, possibly due to the semivertical position used when breastfeeding, which reduces reflux to the eustachian tubes. Exclusive breastfeeding is recommended for the first 6 months. However, this client is age 1 and should be receiving a varied, healthy intake of solid food at this time. (Option B) Day care attendance is a significant risk factor to the development of OM. However, the recommendation to avoid day care is usually not practical as many parents must work outside of the home. (Option C) Excess water in the ears from bathing or swimming can alter the protective environment of the external ear and contribute to otitis externa, known as swimmer's ear; however, this does not contribute to OM. Educational objective: Otitis media, inflammation of the middle ear, commonly occurs in children under age 2. Key interventions for prevention include avoiding exposure to tobacco smoke, obtaining routine immunizations, and discontinuing use of a pacifier after age 6 months.

A 1-Year-Old Child Who Goes to Day Care Is Recovering