Certified Pediatric Nurse (CPN)

In assessing a 10-month-old with recurrent otitis media, what question should the nurse prioritize?

1. Does water ever get into the baby's ears during shampooing?

2. Do you give the baby a bottle to take to bed?

3. Have you noticed a lot of wax in the baby's ears?

4. Can the baby combine 2 words when speaking?

The correct answer is: Do you give the baby a bottle to take to bed?

Prioritizing the question about whether the baby is given a bottle to take to bed is essential because this practice is closely linked to the development of recurrent otitis media (middle ear infections) in infants and young children. When a baby is put to bed with a bottle, especially if the bottle contains anything other than water, the liquid can pool in the back of the throat. This can lead to fluid build-up in the middle ear through the eustachian tube, increasing the risk of infection. Understanding this behavior allows the nurse to provide critical education on preventive measures, such as avoiding bottle-feeding during sleep. This intervention can significantly reduce the frequency of otitis media episodes in the child, thus directly addressing the recurrent nature of the condition. The other questions, while they may be relevant in different contexts, do not address such direct preventive strategies. Questions about water getting into the ears or the presence of wax focus more on immediate ear health rather than the behaviors contributing to recurrent infections. The question about language development, while important in assessing overall growth and development, does not have a causal relationship with recurrent otitis media. Hence, prioritizing the inquiry about bedtime bottle use effectively targets a crucial factor in managing and preventing further episodes of ear infections