The nurse is assessing the tympanic membranes of an infant. Which action by the nurse demonstrates proper technique?

A) Pulls the auricle upward and backward.
B) Holds handle of the otoscope between the thumb and little finger.
C) Uses an inverted otoscope grip while pulling the auricle downward and back.
D) Places the handle of the otoscope between the thumb and index finger while pulling the auricle upward.

Using the inverted otoscope grip while pulling the auricle downward and back is a common approach with infant/child examinations because it prevents accidental movement of the otoscope deeper into the ear canal, as could occur with an unexpected pediatric reaction to the ear examination. The other techniques could result in injury to the infant's tympanic membrane. Insert the scope while pulling the auricle upward and backward in the adult and older child. Hold the handle of the otoscope in the space between the thumb and index finger, supported on the middle finger.