Ni Ketut Alit ANursing 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 (10th 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 ASSESMENTFear of losing hearingDeny that the change occurred

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

Write down education guide for client post surgery with mastoiditis!!