Final Review Nsg 6420 Questions and Answers| Nsg Study Guide

OTITIS EXTERNA- cellulitis of external auditory canal “Swimmers ear” Malignant (necrotizing) seen immunocompromised and diabetes mellitus. Organisms Pseudomonas aeruginosa and Staphylococcus aureus. Fungi- Candida and Aspergillus (chronic) Clinical presentation- acute pain on outside with 48 hours With feelings fullness, itching, drainage, hearing loss Physical exam- tenderness palpation to tragus, canal erythematous and edematous enlarged periauricular lymph nodes. Chronic externa- Dry Cerumen absent, LABS- culture and sensitivity, KOH prep on drainage TREATMENT1- gently remove debris 2- NSAIDS 3- Topical anesthetic (IF TM IS INTACT) a. Benzocaine otic solution (re-check 2 daysish) 4- Topical antibiotics cover to cover both P. aeruginosa & S. aureus a. Fluoroquinolone ofloxacin, ciprofloxacin BID x 7 days b. combo ciprofloxacin & hydrocortisone c. Aminoglycoside neomycin (S. aures not P ) combine w/polymyxin (ototoxicity INTACT TM) Fungal- acetic acid (white vinegar) vinegar to alcohol is effective 1:1 or 1:2 P. aeruginosa-> Malignant otitis externa older adults immunocompromised and diabetes BACTERIAL CONJUNCTIVITIS- “PINK EYE”