MVU NURS 629 Exam 3 LATEST DOCUMENT FOR REVISION

MVU NURS 629 Exam 3 LATEST DOCUMENT FOR REVISION 1 Acute Otitis Media: Causative Organisms: ■ S. Pneumonia (most common) ■ H. Influenzae ■ M. Catarrhalis Subjective/Objective: ■ Fever ■ Pain ■ Discharge from ear canal ■ Tugging at ears ■ Irritability/fussiness ■ Crying ■ Lethargy ■ Anorexia ■ Insomnia ■ Recent URI ■ Red/bulging TM ■ Retracted TM ć of pus ■ Inability to see landmark ■ Visible perforation of TM Treatment: ■ S concurrent conjunctivitis (s. pneumonia) ● Amoxicillin 90mg/kg/day b.i.d., x10 days ■ C concurrent conjunctivitis (h. influenzae) ● Augmentin 90mg/kg/day b.i.d., x10 days ■ PCN Type 1 Allergy: (anaphylaxis) ● Azithromycin PO ● IM rocephin x3 days ■ PCN Non-Type 1 Allergy: (rash) ● Cefdinir PO Otitis Externa: Causative Organisms: ■ Pseudomonas aeruginosa (20-60%) ■ Staph aureus ■ Fungal/candidal Predisposing Factors: ■ Frequent moisture (swimming) ■ Local trauma ■ Aggressive cleaning ■ Allergies/skin conditions Subjective/Objective: ■ Discharge ■ Low-grade fever ■ Pain with tragus manipulation ■ Decreased hearing ■ Redness around outer ear ■ Otalgia (inner or outer) ■ Discharge ■ Feeling of fullness ■ Pruritus Treatment: ■ Warm compresses ■ Auralgan (antipyrine-benzocaine-glycerin) ● Anesthetic, analgesic, wax softener ■ Prednisone ■ acetaminophen/ibuprofen ■ Use of a wick esp if lumen is 50%, ensures delivery of medication to needed site ■ neomycin/polymyxin b/hydrocortisone otic ● Antibiotic & steroid ■ Oflaxacin otic; ciprofloxacin otic ● Antibiotic 2 Pharyngitis: Typically viral Bacterial- group A hemolytic strep Strep Pharyngitis: ■ Subjective/Objective: ● Fever 103 ● Rapid onset of sore throat ● Swollen glands ● Abdominal pain ● Headache ● Anorexia ● Lack of URI s/sx ● Dysphagia ● Irritability ● Exudative tonsils ● Rash (scarlatina) ● Strawberry tongue ● Anterior cervical lymphadenopathy ■ Treatment: ● Amoxicillin 5mg/kg/day x10 days ● If allergy use cephalosporin or macrolide (azithromycin) ● Warm water gargles ● acetaminophen/ibuprofen ■ Education: ● Contagious, may return to school after 24hrs on an abx ● Discard toothbrush after 24hs on an abx and after treatment completion Scarlet Fever: ■ Occurs secondary to strep throat and progresses to acute rheumatic fever s intervention ■ Rare ■ Subjective/Objective: ● Scarlatina begins on face and spreads down and out ● Strawberry tongue ● Fever ● Pharyngitis ■ Treatment: ● amoxicillin 50-80 mg/kg/day x7 days Mononucleosis Pharyngitis