Nurs 629 Exam 3 (Maryville)
Causative organisms for otitis externa: - CORRECT ANSWER-Psuedomonas
aeruginosa (20-60%); Staphylococcus Aureus (10-70%); 10% fungal infection
Symptoms of otitis externa: - CORRECT ANSWER-Discharge from ear, recent
history of swimming or placing something in the ear, low-grade fever, pain with
movement of tragus, decreased hearing, redness around ear
Objective findings of otitis externa: - CORRECT ANSWER-Otalgia ( inner or outer
ear pain), discharge, fullness, itching, pain with movement of tragus, redness
around ear, decreased hearing.
Treatment of pain and therapeutic management of otitis externa: - CORRECT
ANSWER-Warm compresses, Auralgan, prednisone, Tylenol/ibuprofen, Wick (abx
applied to wick )
When to wick with otitis externa: - CORRECT ANSWER-If lumen is reduced to
>50%, wicks can help ensure delivery of topical abx to medial canal.
Treatment of otitis externa: - CORRECT ANSWER-Topical fluroquinolones
(Ciprofloxacin, Ofloxacin), ibuprofen and apap for pain, neomycin/polymixin
b/hydrocortison otic (antibiotic/steroid)
Hallmark sign of otitis externa: - CORRECT ANSWER-Traction of pinna elicits
pain
When do we begin hearing tests in clinic for children - CORRECT ANSWER-4
years old
What is a normal audiology test result and how are results read - CORRECT
ANSWER-Normal -10 to +15 The higher the number, the greater the loss, Severe
loss 71-90 (learning disability, limited vocabulary), Profound loss 90
Risk factors related to elevated cholesterol - CORRECT ANSWER-Obesity,
Diabetes, Hypertension, Family history: Coronary heart disease prior to age 55,
Hyperlipidemia, Diabetes
Clinical findings for tetralogy of Fallot: - CORRECT ANSWER-Cyanosis: caused
by blood low in oxygen, Shortness of breath and rapid breathing, especially
during feeding or exercise, Loss of consciousness, Clubbing of fingers and toes,
Poor weight gain, delayed growth, Polycythemia, metabolic acidosis, Systolic
murmur at 2nd left ICS & holosystolic murmur at LLSB
,What criteria would you have to consider inpatient admission in a patient with
pneumonia - CORRECT ANSWER-Infants less than 4 months old, Infant with poor
feeding, grunting, O2 saturation <92%, respiratory rate >70 , Older child with
grunting, inability to tolerate oral intake, oxygen saturation ≤ 92 percent,
respiratory rate > 50 breaths per minute, Any age: Comorbidities (e.g., chronic
lung disease, asthma, unrepaired or incompletely repaired congenital heart
disease, diabetes mellitus, neuromuscular disease)
Visual acuity of a 2-month-old - CORRECT ANSWER-• Vision is 20/400 • Fix and
follow objects
Viral conjunctivitis etiology (causative agent): - CORRECT ANSWER-Adenovirus
is the most common cause. Other causes: HSV, herpes zoster, and varicella
Viral conjunctivitis symptoms: - CORRECT ANSWER-o Watery discharge (profuse
and clear), foreign body sensation, redness o URI symptoms are common
including sore throat and fever o Itchy conjunctiva and swollen eye lids o Often
bilateral
Viral conjunctivitis Clinical findings - CORRECT ANSWER-o Normal visual acuity,
PERRLA, EOMI, Fundus normal o Mucoid-profuse watery discharge o Mild,
diffuse injection and itching o *Preauricular lymphadenopathy
Viral conjunctivitis Treatment: - CORRECT ANSWER-Symptomatic Only - Warm or
cool compresses, Strict hand hygiene
Pharyngitis - CORRECT ANSWER-Typically viral
Causative organism for bacterial pharyngitis - CORRECT ANSWER-Group A Beta
Hemolytic strep
Subjective findings for strep pharyngitis: - CORRECT ANSWER-Rapid onset of
sore throat, abdominal pain, headache, dysphasiay
Otitis media pathogens - CORRECT ANSWER-Caused by: S. Pneumoniae (most
common); H. Influenzae, M. Catarrhils
Otitis media Symptoms: - CORRECT ANSWER-Fever, Pain, discharge from ear,
tugging at ear, irritability, crying, lethargy, decreased appetite, decreased sleep,
Recent URI
Objective findings in otitis media - CORRECT ANSWER-Red, bulging OM;
Retracted with pus; no movement of TM, Inability to see landmarks; occasional
hole in TM
, Treatment for AOM + Conjunctivitis d/t : H. Influenzae - CORRECT ANSWER-
Amoxicillin-clavulanate 80-90 mg/kg/day BID x 10 days
Treatment for AOM d/t S. Pneumoniae (most common): - CORRECT ANSWER-
Amoxicillin 80-90 mg/kg/day BID x 10 days (high dose)
Treatment for AOM with PCN Allergy: Non-Type 1: - CORRECT ANSWER-Cefdinir,
Cefuroxime
Treatment for AOM with PCN Allergy: Type 1: - CORRECT ANSWER-
Azithromycin, clarithromycin OR Ceftriaxone 1-3 days
Predisposing factors of otitis externa: - CORRECT ANSWER-Frequent moisture,
local trauma, aggressive cleaning, Allergies/skin conditions
Objective findings for strep pharyngitis: - CORRECT ANSWER-Fever >103,
Swollen glands, anorexia, lack of uri s/sx, irritability, Exudative tonsils, scarlatina
rash, strawberry tongue, anterior cervical lymphadenopathy
Treatment for strep pharyngitis - CORRECT ANSWER-Amoxicillin 5mg/kg/day x10
days
If allergy to first line tx for strep pharyngitis, what do you prescribe? - CORRECT
ANSWER-Cephalosporin or macrolide (azithromycin)
Therapeutic tx for strep pharyngitis (in addition to abx) - CORRECT ANSWER-
Warm water gargle/apap/ibu
Education re strep pharyngitis: - CORRECT ANSWER-Discard toothbrush after
24hs on an abx and after treatment completion
When may pt return to school with strep pharyngitis: - CORRECT ANSWER-This
is contagious. May return to school after 24 hours on abx
Scarlet fever: - CORRECT ANSWER-Occurs secondary to strep throat and
progresses to acute rheumatic fever if no intervention
Is scarlet fever common or rare? - CORRECT ANSWER-Rare
Subjective/Objective findings of scarlet fever: - CORRECT ANSWER-Scarlatina
begins on face and spreads down and out/strawberry tongue/Fever/pharyngitis
Causative organisms for otitis externa: - CORRECT ANSWER-Psuedomonas
aeruginosa (20-60%); Staphylococcus Aureus (10-70%); 10% fungal infection
Symptoms of otitis externa: - CORRECT ANSWER-Discharge from ear, recent
history of swimming or placing something in the ear, low-grade fever, pain with
movement of tragus, decreased hearing, redness around ear
Objective findings of otitis externa: - CORRECT ANSWER-Otalgia ( inner or outer
ear pain), discharge, fullness, itching, pain with movement of tragus, redness
around ear, decreased hearing.
Treatment of pain and therapeutic management of otitis externa: - CORRECT
ANSWER-Warm compresses, Auralgan, prednisone, Tylenol/ibuprofen, Wick (abx
applied to wick )
When to wick with otitis externa: - CORRECT ANSWER-If lumen is reduced to
>50%, wicks can help ensure delivery of topical abx to medial canal.
Treatment of otitis externa: - CORRECT ANSWER-Topical fluroquinolones
(Ciprofloxacin, Ofloxacin), ibuprofen and apap for pain, neomycin/polymixin
b/hydrocortison otic (antibiotic/steroid)
Hallmark sign of otitis externa: - CORRECT ANSWER-Traction of pinna elicits
pain
When do we begin hearing tests in clinic for children - CORRECT ANSWER-4
years old
What is a normal audiology test result and how are results read - CORRECT
ANSWER-Normal -10 to +15 The higher the number, the greater the loss, Severe
loss 71-90 (learning disability, limited vocabulary), Profound loss 90
Risk factors related to elevated cholesterol - CORRECT ANSWER-Obesity,
Diabetes, Hypertension, Family history: Coronary heart disease prior to age 55,
Hyperlipidemia, Diabetes
Clinical findings for tetralogy of Fallot: - CORRECT ANSWER-Cyanosis: caused
by blood low in oxygen, Shortness of breath and rapid breathing, especially
during feeding or exercise, Loss of consciousness, Clubbing of fingers and toes,
Poor weight gain, delayed growth, Polycythemia, metabolic acidosis, Systolic
murmur at 2nd left ICS & holosystolic murmur at LLSB
,What criteria would you have to consider inpatient admission in a patient with
pneumonia - CORRECT ANSWER-Infants less than 4 months old, Infant with poor
feeding, grunting, O2 saturation <92%, respiratory rate >70 , Older child with
grunting, inability to tolerate oral intake, oxygen saturation ≤ 92 percent,
respiratory rate > 50 breaths per minute, Any age: Comorbidities (e.g., chronic
lung disease, asthma, unrepaired or incompletely repaired congenital heart
disease, diabetes mellitus, neuromuscular disease)
Visual acuity of a 2-month-old - CORRECT ANSWER-• Vision is 20/400 • Fix and
follow objects
Viral conjunctivitis etiology (causative agent): - CORRECT ANSWER-Adenovirus
is the most common cause. Other causes: HSV, herpes zoster, and varicella
Viral conjunctivitis symptoms: - CORRECT ANSWER-o Watery discharge (profuse
and clear), foreign body sensation, redness o URI symptoms are common
including sore throat and fever o Itchy conjunctiva and swollen eye lids o Often
bilateral
Viral conjunctivitis Clinical findings - CORRECT ANSWER-o Normal visual acuity,
PERRLA, EOMI, Fundus normal o Mucoid-profuse watery discharge o Mild,
diffuse injection and itching o *Preauricular lymphadenopathy
Viral conjunctivitis Treatment: - CORRECT ANSWER-Symptomatic Only - Warm or
cool compresses, Strict hand hygiene
Pharyngitis - CORRECT ANSWER-Typically viral
Causative organism for bacterial pharyngitis - CORRECT ANSWER-Group A Beta
Hemolytic strep
Subjective findings for strep pharyngitis: - CORRECT ANSWER-Rapid onset of
sore throat, abdominal pain, headache, dysphasiay
Otitis media pathogens - CORRECT ANSWER-Caused by: S. Pneumoniae (most
common); H. Influenzae, M. Catarrhils
Otitis media Symptoms: - CORRECT ANSWER-Fever, Pain, discharge from ear,
tugging at ear, irritability, crying, lethargy, decreased appetite, decreased sleep,
Recent URI
Objective findings in otitis media - CORRECT ANSWER-Red, bulging OM;
Retracted with pus; no movement of TM, Inability to see landmarks; occasional
hole in TM
, Treatment for AOM + Conjunctivitis d/t : H. Influenzae - CORRECT ANSWER-
Amoxicillin-clavulanate 80-90 mg/kg/day BID x 10 days
Treatment for AOM d/t S. Pneumoniae (most common): - CORRECT ANSWER-
Amoxicillin 80-90 mg/kg/day BID x 10 days (high dose)
Treatment for AOM with PCN Allergy: Non-Type 1: - CORRECT ANSWER-Cefdinir,
Cefuroxime
Treatment for AOM with PCN Allergy: Type 1: - CORRECT ANSWER-
Azithromycin, clarithromycin OR Ceftriaxone 1-3 days
Predisposing factors of otitis externa: - CORRECT ANSWER-Frequent moisture,
local trauma, aggressive cleaning, Allergies/skin conditions
Objective findings for strep pharyngitis: - CORRECT ANSWER-Fever >103,
Swollen glands, anorexia, lack of uri s/sx, irritability, Exudative tonsils, scarlatina
rash, strawberry tongue, anterior cervical lymphadenopathy
Treatment for strep pharyngitis - CORRECT ANSWER-Amoxicillin 5mg/kg/day x10
days
If allergy to first line tx for strep pharyngitis, what do you prescribe? - CORRECT
ANSWER-Cephalosporin or macrolide (azithromycin)
Therapeutic tx for strep pharyngitis (in addition to abx) - CORRECT ANSWER-
Warm water gargle/apap/ibu
Education re strep pharyngitis: - CORRECT ANSWER-Discard toothbrush after
24hs on an abx and after treatment completion
When may pt return to school with strep pharyngitis: - CORRECT ANSWER-This
is contagious. May return to school after 24 hours on abx
Scarlet fever: - CORRECT ANSWER-Occurs secondary to strep throat and
progresses to acute rheumatic fever if no intervention
Is scarlet fever common or rare? - CORRECT ANSWER-Rare
Subjective/Objective findings of scarlet fever: - CORRECT ANSWER-Scarlatina
begins on face and spreads down and out/strawberry tongue/Fever/pharyngitis
