The primary care pediatric nurse practitioner obtains a tympanogram on a child that reveals a sharp peak of -180 mm H₂O. What does this value indicate?

Choice A reason: Middle ear effusion typically results in a flat tympanogram (Type B), indicating poor mobility of the tympanic membrane due to fluid accumulation. A sharp peak is not characteristic of effusion. Choice B reason: Tympanic membrane perforation is also associated with a flat tympanogram or large ear canal volume, not a sharp negative peak. Choice C reason: A sharp peak at -180 mm H₂O indicates Type C tympanogram, which reflects negative middle ear pressure. This is often due to eustachian tube dysfunction and may precede or follow an effusion. Choice D reason: A normal tympanic membrane shows a peak near 0 mm H₂O (Type A tympanogram). A peak at -180 mm H₂O is outside the normal range and indicates pathology.