A school nurse performs a routine screening on a newly transferred school-age child.This nurse is especially interested in discovering the child's medical history regarding middle ear infections.The nurse knows that chronic ear infections are a major contributing factor to which of the following?

A) Respiratory diseases
B) Strep throat
C) High fevers
D) Hearing impairment

Hearing impairment is common in the United States.At-risk children include those with a family history of childhood hearing impairment,perinatal infection (rubella,herpes,or cytomegalovirus),low birth weight,chronic ear infections,and Down syndrome.Children need periodic auditory testing.Advise pregnant women of the importance of early prenatal care,avoidance of ototoxic drugs,and testing for syphilis and rubella.Strep throat,high fevers,and respiratory diseases are potential contributing factors for chronic ear infections.