A 2-year-old girl presents to the community health clinic accompanied by her grandmother. Her grandmother explains that the client awoke crying in the early hours of the morning. The child was inconsolable and was observed pulling at her R ear and saying "ouch!" Her grandmother reports administering a dose of children's Tylenol about 6 hours ago to help relieve the pain. A review of the client's chart reveals she was treated conservatively for a viral upper respiratory infection five days ago, and symptoms have mostly resolved with the exception of a slight runny nose. She is concerned that the child may have developed an ear infection because she is prone to them. Vital signs during patient intake include: HR 110 bpm, temp 102.2°F temporal, RR 25. The patient appears sleepy and is cupping the right ear.
1) The nurse prepares to perform a focused physical examination of the client. Appropriate examination of this client will include: (Select all that apply.)
a. Collect the ophthalmoscope for examination.
b. Palpate the pinna and tragus. Inspect the tympanic membrane.
c. Exam the affected ear first Pull the ear lobe up and back during inspection of the ear canal.
d. Palpate the incus and stapes. Inspect the Stenson ducts.
e. Pull the ear lobe down during inspection of the ear canal.
f. Exam the well ear first Collect the otoscope for examination.