Case Study A four-month-old boy and his parent present to the pediatrician's office as follows: Subjective Data: Mom states that her son has been tugging at his right ear and woke up crying in the middle of the night, two nights ago. She gave the child Ibuprofen and his bottle, and he went back to sleep. Last night, he woke up in pain and was inconsolable. The child's mother had taken him to the pediatrician two weeks prior due to a "runny nose but he has otherwise been well since." The infant now is "more irritable and restless" than normal and the mother would like him to be seen again. His mother works full time and smokes ½ pack of cigarettes per day to cope with the stress of raising a child as a single parent. The infant lives with his extended family and attends a daycare program 5 days a week. Objective Data: His vital signs are within normal limits for his age, except for an oral temperature of 38.5 C. His lungs are clear to auscultation, there are no other abnormal findings on examination. On otoscopic examination, you see a bulging and erythematous right tympanic membrane. His left tympanic membrane is normal. The infant is diagnosed with acute otitis media (AOM).

Case Study A four-month-old boy and his parent present to the pediatrician's office as follows: Subjective Data: Mom states that her son has been tugging at his right ear and woke up crying in the middle of the night, two nights ago. She gave the child Ibuprofen and his bottle, and he went back to sleep. Last night, he woke up in pain and was inconsolable. The child's mother had taken him to the pediatrician two weeks prior due to a "runny nose but he has otherwise been well since." The infant now is "more irritable and restless" than normal and the mother would like him to be seen again. His mother works full time and smokes ½ pack of cigarettes per day to cope with the stress of raising a child as a single parent. The infant lives with his extended family and attends a daycare program 5 days a week. Objective Data: His vital signs are within normal limits for his age, except for an oral temperature of 38.5 C. His lungs are clear to auscultation, there are no other abnormal findings on examination. On otoscopic examination, you see a bulging and erythematous right tympanic membrane. His left tympanic membrane is normal. The infant is diagnosed with acute otitis media (AOM).