FNP Pediatric Exam A+ Pass
Verified
Leading causes of death and prevention - Answer- Diarrhea and pneumonia are leading
causes of childhood mortality and morbidity
Rotavirus and strep pneumonia (vaccine-preventable diseases) most common causes
Successful vaccination programs are effective
What effects global food - Answer- Hunger and under-nutrition occur without access to
safe, nutritious foods
Climate change and its effects on crops and food
distribution
Undernutrition an important determinant of maternal/child health
Breastfeeding increases survival rates
American Academy of Pediatrics recommendation for preventative pediatric health care
- Answer- Uncoupling of periodicity of visits and immunizations to a greater emphasis
on healthy growth/developmental surveillance
Health literacy Chpt 2 - Answer- All children need nurturing and attention from adults in
their lives
Mother's education levels, beliefs/attitudes about health, health practices affect health of
children
Parental stress/mental illness affect health care
Maternal depression in 1st year of life associated with
poor caregiving leading to poor language
development
Maternal depression predictive of asthma symptoms
in inner-city African-American families
Lack of consistent, affectionate attention can have devastating results
"Poor fit" between child and adult can cause later social adjustment issues
Otitis Media signs and symptoms/ treatment - Answer- Accurate diagnosis
Rapid onset of otalgia, middle ear effusion
Confirmed with pneumatic otoscopy/tympanogram
signs of middle ear inflammation
Pain management
Antipyretics/analgesics
Distraction, oil application, external heat/cold
Initial observation versus antibiotics
Appropriate antibiotic choice
•Amoxicillin
,•Augmentin
Preventive measures
Plan for recurrence
•Referral if indicated
Pressure-Equalizing Tubes - Answer- Clinical practice guidelines - refer if recurrent
AOM 3 times/6 months or 4 times/year
otits externa signs and symptoms - Answer- Diffuse inflammation of external ear canal
(EAC); may involve pinna, TM
Simple infection - edema, discharge, erythema
Furuncles or small abscesses in hair follicles
Impetigo or infection in superficial epidermis
Most frequently by retained moisture in EAC
Usually acidic environment changes to neutral or
basic
Chlorine kills normal ear flora
Regular cleaning removes the cerumen barrier
Soap, local trauma, sweating, allergy, stress can
contribute
P. aeruginosa, S. aureus most common; may be polybacterial
otitis externa treatment - Answer- inflammation of the outer ear
Eardrops: cipro; acetic acid drops might be effective in mild episodes; antibiotics with
steroid otic drops are the treatment of choice. Symptoms should be improved in 7 days
but can take up to 2 weeks.
Avoid ototoxic drops if risk of perforation
Systemic antibiotics not used unless severe
Thorough patient education about drops
Use a wick if significant swelling
Avoid cleaning, manipulating, getting water into ear - no swimming
Analgesics for pain
Debridement with cotton-tipped applicator
Clean canal with water or antiseptic solution if impetigo and apply antibiotic ointment
, Treat fungal infections with clotrimazole-miconazole, or nystatin
Otitis Externa (Swimmer's Ear) clinical findings - physical examination - Answer- Pain
with movement of tragus or pinna or with attempts to examine with otoscope
Swollen EAC with debris
Rare otorrhea
Occasional regional lymphadenopathy
Red, crusty, or pustular lesions
Pruritis associated with thick, black, gray, blue-green, yellow, or white otorrhea
(mycosis)
Dry-appearing canal/atrophy with chronic OE
Presence of PET or perforation of TM
Otitis Externa (Swimmer's Ear) Prevention - Answer- Avoid water in ear canals
Well-fitting earplugs for swimming
Alcohol/vinegar/distilled water otic mix (2:1:1); 3-5 drops daily, especially after
swimming
Blow dryer on warm setting to dry EAC
Avoid persistent scratching/cleaning of EAC
Avoid prolonged use of cerumenolytic agents
Otits Media (OM) signs and symptoms - Answer- Acute infection of middle ear
AAP guideline: presence of three components to diagnose AOM:
Recent, abrupt onset of middle ear inflammation and
effusion (pain, irritability, otorrhea, fever)
MEE confirmed by bulging TM, limited/absent
mobility by pneumatic otoscopy, air-fluid level
behind TM, otorrhea
Signs/symptoms of inflammation - distinct erythema of TM, pain
Clinical Findings (history)
Rapid onset of symptoms
Ear pain/pulling in infant
Irritability in infant/toddler
Otorrhea
Fever
otitis media (OM) causes - Answer- S. pneumoniae, nontypeable H. influenzae, M.
catarrhalis, and S. pyogenes are most common
Viruses usually initial causative factor, but most AOM caused by bacteria or
combination bacteria/virus
Eustachian tube dysfunction (ETD)
Common causes of ETD:
Verified
Leading causes of death and prevention - Answer- Diarrhea and pneumonia are leading
causes of childhood mortality and morbidity
Rotavirus and strep pneumonia (vaccine-preventable diseases) most common causes
Successful vaccination programs are effective
What effects global food - Answer- Hunger and under-nutrition occur without access to
safe, nutritious foods
Climate change and its effects on crops and food
distribution
Undernutrition an important determinant of maternal/child health
Breastfeeding increases survival rates
American Academy of Pediatrics recommendation for preventative pediatric health care
- Answer- Uncoupling of periodicity of visits and immunizations to a greater emphasis
on healthy growth/developmental surveillance
Health literacy Chpt 2 - Answer- All children need nurturing and attention from adults in
their lives
Mother's education levels, beliefs/attitudes about health, health practices affect health of
children
Parental stress/mental illness affect health care
Maternal depression in 1st year of life associated with
poor caregiving leading to poor language
development
Maternal depression predictive of asthma symptoms
in inner-city African-American families
Lack of consistent, affectionate attention can have devastating results
"Poor fit" between child and adult can cause later social adjustment issues
Otitis Media signs and symptoms/ treatment - Answer- Accurate diagnosis
Rapid onset of otalgia, middle ear effusion
Confirmed with pneumatic otoscopy/tympanogram
signs of middle ear inflammation
Pain management
Antipyretics/analgesics
Distraction, oil application, external heat/cold
Initial observation versus antibiotics
Appropriate antibiotic choice
•Amoxicillin
,•Augmentin
Preventive measures
Plan for recurrence
•Referral if indicated
Pressure-Equalizing Tubes - Answer- Clinical practice guidelines - refer if recurrent
AOM 3 times/6 months or 4 times/year
otits externa signs and symptoms - Answer- Diffuse inflammation of external ear canal
(EAC); may involve pinna, TM
Simple infection - edema, discharge, erythema
Furuncles or small abscesses in hair follicles
Impetigo or infection in superficial epidermis
Most frequently by retained moisture in EAC
Usually acidic environment changes to neutral or
basic
Chlorine kills normal ear flora
Regular cleaning removes the cerumen barrier
Soap, local trauma, sweating, allergy, stress can
contribute
P. aeruginosa, S. aureus most common; may be polybacterial
otitis externa treatment - Answer- inflammation of the outer ear
Eardrops: cipro; acetic acid drops might be effective in mild episodes; antibiotics with
steroid otic drops are the treatment of choice. Symptoms should be improved in 7 days
but can take up to 2 weeks.
Avoid ototoxic drops if risk of perforation
Systemic antibiotics not used unless severe
Thorough patient education about drops
Use a wick if significant swelling
Avoid cleaning, manipulating, getting water into ear - no swimming
Analgesics for pain
Debridement with cotton-tipped applicator
Clean canal with water or antiseptic solution if impetigo and apply antibiotic ointment
, Treat fungal infections with clotrimazole-miconazole, or nystatin
Otitis Externa (Swimmer's Ear) clinical findings - physical examination - Answer- Pain
with movement of tragus or pinna or with attempts to examine with otoscope
Swollen EAC with debris
Rare otorrhea
Occasional regional lymphadenopathy
Red, crusty, or pustular lesions
Pruritis associated with thick, black, gray, blue-green, yellow, or white otorrhea
(mycosis)
Dry-appearing canal/atrophy with chronic OE
Presence of PET or perforation of TM
Otitis Externa (Swimmer's Ear) Prevention - Answer- Avoid water in ear canals
Well-fitting earplugs for swimming
Alcohol/vinegar/distilled water otic mix (2:1:1); 3-5 drops daily, especially after
swimming
Blow dryer on warm setting to dry EAC
Avoid persistent scratching/cleaning of EAC
Avoid prolonged use of cerumenolytic agents
Otits Media (OM) signs and symptoms - Answer- Acute infection of middle ear
AAP guideline: presence of three components to diagnose AOM:
Recent, abrupt onset of middle ear inflammation and
effusion (pain, irritability, otorrhea, fever)
MEE confirmed by bulging TM, limited/absent
mobility by pneumatic otoscopy, air-fluid level
behind TM, otorrhea
Signs/symptoms of inflammation - distinct erythema of TM, pain
Clinical Findings (history)
Rapid onset of symptoms
Ear pain/pulling in infant
Irritability in infant/toddler
Otorrhea
Fever
otitis media (OM) causes - Answer- S. pneumoniae, nontypeable H. influenzae, M.
catarrhalis, and S. pyogenes are most common
Viruses usually initial causative factor, but most AOM caused by bacteria or
combination bacteria/virus
Eustachian tube dysfunction (ETD)
Common causes of ETD:
