A nurse is assessing a postmature infant. Which of the following findings would the nurse expect? (Select All that Apply.)

A. Dysmenorrhea that is unresponsive to NSAIDs. Endometriosis often causes severe pelvic pain that does not improve with NSAIDs, distinguishing it from typical menstrual cramps.
B. A history of pelvic inflammatory disease (PID). PID is not directly associated with endometriosis and typically presents differently.
C. Abdominal bloating starting several days before menses. While bloating can occur with endometriosis, it is not a definitive symptom for diagnosis.
D. An atypical Papanicolaou smear at her last clinic visit. An atypical Pap smear is more related to cervical abnormalities, not endometriosis.

Complication: Otitis Media

Anatomical Changes:

• Small external ear structure: Infants born with a cleft palate often have smaller external ear structures, which can affect the drainage of fluids and increase the risk of infections.
• Horizontal eustachian tubes: Eustachian tubes in individuals with cleft palate are typically more horizontal than normal, impairing the drainage of fluid from the middle ear.
• Large tongue: A large tongue may obstruct the upper airway and interfere with normal swallowing and speaking functions.

Complication: Otitis Media

• Due to the anatomical changes associated with cleft palate, such as horizontal eustachian tubes and impaired drainage, individuals are prone to recurrent middle ear infections (otitis media). These infections can lead to fluid accumulation behind the eardrum, which can further impair hearing and potentially lead to more serious complications if untreated.

Priority Interventions:

• Ear drops (for otitis media): Ear drops containing antibiotics may be prescribed to treat bacterial infections in the middle ear, which are common in individuals with cleft palate.
  • Rationale: Ear drops help to directly treat the infection in the ear canal and middle ear, reducing inflammation and preventing complications such as hearing loss or spread of infection.
• Corticosteroids (for inflammation): Corticosteroids may be used to reduce inflammation in the ear canal and middle ear, particularly in cases of severe otitis media.
  • Rationale: Corticosteroids help to decrease swelling and inflammation, which can improve symptoms and aid in the healing process of the ear.