NUR 638 Final Exam Study Guide 2023

NUR 638 Final Exam Study Guide 2023. Otitis externa o Risk factors Typically those that compromise the integrity of the inherent defense mechanism against infection – these include removal of protective cerumen with damage to fragile skin that results from vigorous cleaning of the canal; maceration of skin that results from accumulation of moisture within the canal from swimming and alterations to the tissues that result from wearing of devices such as headphones and ear plugs. o Oral antimicrobial therapies, including when cellulitis is present Systemic abx therapy is indicated only if acute otitis externa has extended beyond the canal or if the pt has diabetes or immunocomprimised Fluroquinolone abx are effective against both P. aeruginosa and S. aureus Examples include ofloxacin (Floxin otic) and ciprofloxacin (Cetraxal, Ciloxan). Theses are also available as abx-corticosteroid combinations such as ciprofloxin with hydrocortisone (Cipro HC) to promote resolution of both infection and inflammation. Fluroquinolone are safe to use in pts with nonintact tympanic membranes or tympanostomy tubes Aminoglycoside abx such as neomycin are another option for treating acute otitis externa. Neomycin is effective against S. aureus but not P. aeruginosa, so it is commonly combined with polymyxin B for P. eruginosa coverage in products such as Cortisporin otic. Aminoglycosides carry a risk for ototoxity and should not be used in pts unless the tympanic membrane is verified to be intact. For fungul ??????????????????  Hypertension o Office treatment prior to initiating medications Because multiple factors may transiently increase or decrease BP values, a diagnosis of HTN is usually based on measurements obtained at least 2 office visits. Defined as BP consistently at 140/90 or higher. Routine evaluation of HTN includes urinalysis and complete blood count (CBC) and determination of serum potassium, blood urea nitrogen (BUN), serum creatinine, fasting blood glucose, plasma lipoprotein, serum uric acid, and calcium concentrations. ECG is performed to assess evidence of ischemic heart disease or left ventricular hypertrophy. Left ventricular hypertrophy manifests on ECG w a large S wave in V, and a large R wave in V. These 2 deflections add up to more than 35mm. The initial evaluation of a patient with hypertension shoul dexclude the possibility of secondary hypertension.