Mastoiditis is a condition that affects the mastoid bone, which is a bone located behind the ear. This bone is made up of air cells that help drain fluid from the middle ear. When bacteria or a virus infects the middle ear, it can spread to the mastoid bone and cause inflammation and infection.
Causes of Mastoiditis
Mastoiditis is most commonly caused by a bacterial infection that spreads from the middle ear to the mastoid bone. Inflammation of the mastoid bone can also be caused by a viral infection, although this is less common.
Several factors can increase the risk of developing mastoiditis. These include:
- Untreated or recurrent middle ear infections: Middle ear infections are the most common cause of mastoiditis. When an infection in the middle ear is not treated or keeps coming back, it can spread to the mastoid bone and cause inflammation.
- Weakened immune system: A weakened immune system can make a person more susceptible to infections, including those that can cause mastoiditis.
- Cholesteatoma: A cholesteatoma is a type of skin cyst that can form in the middle ear. If left untreated, a cholesteatoma can erode the bone and cause mastoiditis.
- Head trauma: A severe blow to the head or a skull fracture can also lead to mastoiditis.
- Recent ear surgery: Mastoiditis can develop as a complication of ear surgery, especially if the surgery involves the mastoid bone.
Symptoms of Mastoiditis
Mastoiditis can cause a variety of symptoms that can range from mild to severe. Some of the most common symptoms of mastoiditis include the following:
- Pain, tenderness, or swelling behind the ear
- Redness or warmth in the area behind the ear
- Ear drainage or discharge
- Hearing loss or a feeling of fullness in the ear
- Dizziness or vertigo
- Fatigue or general malaise
- Nausea or vomiting
Nursing Assessment for Mastoiditis
Mastoiditis is a condition in which the mastoid bone behind the ear becomes infected and inflamed. Nursing assessment for mastoiditis involves the following:
- Health History: The nurse will take a detailed health history to identify any risk factors for mastoiditis, such as recent ear infections, upper respiratory infections, or recent trauma to the ear.
- Physical Assessment: The nurse will perform a physical exam to assess for signs and symptoms of mastoiditis, such as pain and tenderness behind the ear, fever, and swelling or redness of the ear.
- Otoscopic Exam: The nurse will use an otoscope to examine the ear canal for signs of infection, such as discharge, redness, or swelling.
- Neurological Exam: The nurse will assess for neurological deficits, such as hearing loss or facial weakness, which may indicate a more severe case of mastoiditis.
- Vital Signs: The nurse will monitor vital signs, such as temperature, blood pressure, and heart rate, as these may indicate the severity of the infection.
- Laboratory Tests: The nurse may order laboratory tests, such as a complete blood count (CBC) and a culture of any drainage from the ear, to confirm the diagnosis and identify the causative organism.
- Pain Assessment: The nurse will assess the patient's pain level using a pain scale to determine appropriate pain management.
- Nutrition Assessment: The nurse will assess the patient's nutritional status and provide education on proper nutrition to support the immune system.
- Education: The nurse will provide education on proper ear hygiene and the importance of completing the full course of antibiotics to prevent recurrence and complications.
Nursing Diagnosis for Mastoiditis
- Acute pain caused by inflammation or infection of the mastoid bones.
- Impairment of immune function can increase the risk of infection.
- Sensitivity impairment due to hearing loss or facial nerve involvement.
Nursing Care Plan for Mastoiditis:
- Acute Pain
- To manage pain, you should take analgesics according to the doctor's instructions.
- To relieve discomfort, warm compresses and warm moist towels can be used.
- Encourage patient to lie down in a comfortable place.
- To reduce pain, teach the patient relaxation techniques.
- Risk for Infection:
- To detect changes in patient's condition, monitor vital signs regularly.
- To prevent any further infection, you should take antibiotics as directed by your doctor.
- Encourage patients to practice good ear hygiene.
- Education about infection prevention is important. This includes frequent hand washing, avoiding contact with sick people and not allowing them to touch you.
- Sensory impairment:
- Regularly assess the patient's hearing ability and facial nerve function.
- Offer emotional support to the patient in order to reduce anxiety and fear related to hearing loss or facial nerve involvement.
- Encourage the patient's caregivers to inform them of any sensory changes.
- To help patients adapt to sensory changes, provide education about the use of assistive technology or communication strategies.
- To ensure proper nutrition and hydration, monitor the patient's fluid and food intake.
- To support the immune system, provide education about proper nutrition and hydration.
- Encourage patients to eat smaller, more frequent meals to keep energy levels high and avoid nausea.