A nurse is preparing to administer ear drops to a 2-year-old child with otitis externa. Which action correctly facilitates proper medication delivery based on the anatomy and function of the ear?

Choice A rationale While lying on the unaffected side might keep the medication in the ear, it does not address the anatomical requirement for straightening the ear canal to ensure the drops reach the target area. The primary concern during administration is ensuring the liquid travels down the external auditory meatus toward the tympanic membrane. Simply lying down without proper manipulation of the external ear structure will likely result in the medication pooling at the entrance of the narrow canal. Choice B rationale In a 2-year-old child, the external auditory canal is shorter and curves upward. To straighten this canal for effective medication delivery, the nurse must gently pull the pinna down and back. This anatomical adjustment aligns the canal, allowing the ear drops to flow directly toward the eardrum. This technique is specific to infants and toddlers under the age of 3 years. After age 3, the technique changes to pulling the pinna up and back. Choice C rationale Pulling the pinna up and back is the correct technique for adults and children older than 3 years of age because their ear canals have a different anatomical orientation. For a 2-year-old, this action would actually make the canal more redundant and harder to penetrate with the medication. Additionally, ear drops for otitis externa are intended for the external ear canal, not the inner ear, which is separated from the external canal by the intact tympanic membrane. Choice D rationale Massaging the mastoid area, which is the bony prominence behind the ear, does not facilitate the absorption of medication into the middle ear. Otitis externa is an infection of the external ear canal, so the medication needs to stay in the canal. To help the drops move inward, the nurse should gently massage the tragus, the small cartilage flap at the front of the ear canal. Massaging the bone behind the ear provides no therapeutic benefit.