100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
NURS 629 Exam 3 STUDY GUIDE $15.49   Add to cart

Exam (elaborations)

NURS 629 Exam 3 STUDY GUIDE

 10 views  1 purchase
  • Course
  • Institution

NURS 629 Exam 3 STUDY GUIDE

Preview 3 out of 22  pages

  • July 9, 2022
  • 22
  • 2021/2022
  • Exam (elaborations)
  • Questions & answers
avatar-seller
NURS 629 Exam 3 STUDY GUIDE
Otitis media ANS - #1 diagnosis is among healthcare providers caring for
children
-By the age of 3, 2/3 of all children will have had an OM: ½ will have >3
occurrences

OM is most common in ANS - boys, first born, winter months, bottle fed
babies, preemies, daycare children, children of smokers

Reason for OM ANS - ■ Eustachian tube is shorter. By the ages 7-12 the
eustachian tube resembles that of an adult
■ Adenoids can be enlarged. If the adenoid that is enlarged d/t smaller nasal
canals & respiratory tract, that can easily block the eustachian tube & not
allow for drainage

Common bacterial causes for OM? ANS - ● S. pneumoniae: most common
● H. influenzae: child presents with conjunctivitis with OM, treat with
Augmentin and topical antibiotic for conjunctivitis
● M. catarrhalis

Symptoms of OM? ANS - ■ Fever, pain, discharge from the ear, tugging or
batting at the ear, irritability, crying, lethargy, decreased appetite,
decreased sleep, recent URI

Clinical Signs of OM? ANS - ■ Red, bulging TM, retracted with pus,
decreased translucency of TM, no movement of the TM, inability to see
normal landmarks, occasionally: hole in the TM

Diagnosis of OM requirements? ANS - ■ History of acute onset
■ Identify presence of middle ear effusion: bulging TM, decreased or absent
mobility of TM, amber fluid or appearance of TM, otorrhea
■ Identify signs of middle ear inflammation: erythematous TM, otalgia
(which interferes with function/sleep)

Tx of OM? ages:
>6m
6m-2yrs
>2yrs ANS - <6m: abx if certain or not
6-12m: abx if : fever >102, bilateral infection, severe otalgia, longer than 7
days (observe if not severe)
>2 yrs: abx if severe ^ observe if not

,Symptoms relief for OM? (non-abx) ANS - ● Acetaminophen or ibuprofen:
mild to moderate pain
● Benzocaine (Auralgan, Amerciaine otic): mild to moderate pain
● Warm compress

ABX tx for OM? ANS - ● Clinically defined treatment failure at 48-72 hours
after initial management with observation or at diagnosis for patients being
initially with antibacterial agents
ABX:
Amoxicillin 80-90 mg/kg/day BID for 10 days
OR IF PCN ALLERGY:
Non-Type 1: Cefdinir, cefuroxime
Type 1: Azithromycin, clarithromycin

OR: SEVERE OM:

Augmentin (Amoxicillin-clavulanate) 80-90 mg/kg/day for 10 days or
PCN alg: Ceftriaxone 1 or 3 days

Signs of bacterial AOM? ANS - • Bulging TM with decreased mobility, acute
onset pain and fever

when do you not 'watch and wait' on AOM? ANS - o Kids younger than 6
months
o \Children 6 mo - 2 years with moderate to severe pain (concerned bc of
speech development during this time)
o 2 and older with high fever
o All children with comorbidities such as heart disease etc

How do you treat AOM in kid who has ear tubes? ANS - Ofloxacin/cipro gtt

If pt develops rash after taking amox for ear infection what do you do? ANS
- stop and start cephalosporin

What are the predisposing factors for otitis externa? ANS - ■ Frequent
exposure to moisture of the ear
■ Aggressive cleaning of the ear canal (do not use Q-tips because that can
cause little micro tears in the skin which can lead to inflammation and
infection)
■ Local trauma to the ear
■ Allergies & skin conditions
■ Eczema

t/f otitis externa is typically bilateral? ANS - F usually unilateral

, symptoms of otitis externa? ANS - ■ Discharge from the ear (especially if
the TM has rupture), low grade fever, recent history of swimming or placing
something in ear, pain with movement of the tragus, redness around ear,
decreased hearing

tx of otitis externa? ANS - ■ Topical antimicrobial for initial therapy of
diffuse AOE should be based upon efficacy, low incidence of adverse events,
likelihood of adherence to therapy, and cost.
■ Pain management: analgesic treatment based on the severity of pain
■ Therapeutic
● Warm compresses, NSAIDs/Tylenol, prednisone, auralgan, OTC benzocaine
drops and then wicking

when should pt with otitis externa return if therapy has failed? ANS - ■ If
the patient fails to respond to the initial therapeutic option within 48-72
hours, the clinician should reassess the patient to confirm the diagnosis of
diffuse AOE and to exclude other causes of illness

what are red flag symptoms of throat pain? ANS - drooling, stridor, or
trouble breathing
Do NOT examine

What type of rash is associated with strep? ANS - sandpaper rash

what are common complications of pharyngitis? ANS - peritonsillar
abscesses, rheumatic fever, post-streptococcal, glomerulonephritis

What are the common signs/symptoms of Group AB strep? ANS - ■
Symptoms: rapid onset of sore throat, fever 103-104, swollen glands,
children often complain of abdominal pain, usually no URI symptoms,
headache, decreased appetite, dysphagia, irritability
■ Signs: exudate tonsils, anterior cervical lymphadenopathy, strawberry
tongue, rash

Diagnostic for strep? ANS - ■ Throat culture: 24 hr is the gold standard,
must swab both tonsils for best results
■ Remember 50% of kids with mono also have strep

what is the common abx for strep? ANS - ■ Amoxicillin (50-80 mg/kg/day)
x 10 days (PCN allergy: cephalosporin or macrolide)
■ Warm water gargles
■ Tylenol/NSAIDs

What causes Mono? ANS - Epstein-Barr virus

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller LeCrae. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $15.49. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

67096 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now

Start selling
$15.49  1x  sold
  • (0)
  Add to cart