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Acute viral rhinitis - ✔✔The most common pediatric infectious disease;
otherwise known as the common cold
14 days - ✔✔How long can symptoms of acute viral rhinitis last?
sudden onset
clear or mucoid rhinorrhea
nasal congestion
fever
sore throat and cough
erythematous nose, throat, and TMs - ✔✔What are the symptoms of acute viral
rhinitis?
S. Pneumoniae
H influenza
M catarrhalis
B-hemolytic strept - ✔✔What are the common pathogens of acute bacterial
rhinosinusitis
Nasal congestion
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,purulent nasal discharge
facial pain/pressure
cough
headache
fever - ✔✔What are the symptoms of acute bacterial rhinosinusitis?
<30 days - ✔✔How long does acute bacterial rhinosinusitis last?
Can be either - ✔✔Is onset of acute bacterial rhinosinusitis gradual or sudden?
10 - ✔✔The general rule of thumb when considering tx for acute bacterial
rhinosinusitis is that diagnosis should not be made until symptoms last longer
than ___ days without improvement OR worsening of symptoms within 10 days
after initial improvement of symptoms
Treat with abx immediately - ✔✔What should the NP do if the pt presents with
focal signs of acute bacterial rhinosinusitis such as periorbital edema, severe
sinus tenderness, or severe headache?
False - ✔✔T or F: Routine sinus X rays are recommended for uncomplicated
acute sinusitis
NSAIDS or acetaminophen - ✔✔All pts with acute bacterial rhinosinusitis should
receive pain/fever control with what meds?
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,<3 days - ✔✔How long can nasal decongestants be used to help symptoms?
intranasal corticosteroids - ✔✔Use of ______________ sprays are
recommended in all adults and may be useful for children with underlying
allergic sinusitis
4 - ✔✔Use of OTC oral decongestant, antihistamines and cough/cold preps are
NOT recommended in children <_____ years of age.
Pain medication
humidified air
saline nose drops - ✔✔A child comes in with acute nasal congestion and
rhinosinusitis x10 days. The NP understands this is most likely an upper
respiratory tract infection (viral). What would the tx regimen consist of?
Amoxicillin 80-90 mg/kg/day divided bid or amoxicillin-clavulanate 80-90
mg/kg/day divided bid for x10-14 days - ✔✔A child comes to the clinic with
acute nasal congestion and rhinosinusitis with mild symptoms x10-14 days
without any improvement. The NP understands this is likely bacterial sinusitis.
What is the first line abx and duration of tx?
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, cephalosporin or amoxicillin-clavulanate - ✔✔A child with bacterial
rhinosinusitis is being treated with amoxicillin and symptoms have not
improved after 3 days. What is the second line abx that would be initiated?
Beta-lactamase stable abx - ✔✔A child with severe symptoms or
immunosuppressed has acute bacterial rhinosinusitis. What is the abx of
choice?
Recurrent sinusitis - ✔✔Defined as successive episodes of bacterial infections of
the sinuses, each lasting less than 30 days & separated by intervals of at least 10
days
Chronic sinusitis - ✔✔Defined as episodes of inflammation of the paranasal
sinuses lasting more than 90 days
3-4 weeks - ✔✔Tx for chronic and recurrent sinusitis is the same as for acute,
except the duration of tx is ______ weeks.
Allergic rhinitis - ✔✔Contributes to development of sinusitis and asthma
exacerbations. Also known as hay fever.
Most common in children with red hair. Allergic rhinitis, asthma, and eczema -
✔✔What is known as the triad?
sneezing
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