Review for Test 2
Pediatrics
● What are the symptoms of otitis media and how is it treated medically or surgically?
○ Symptoms: pg. 1128
■ AOM - acute otitis media (usually caused by infection)
● Acute onset of ear pain
● Screaming, pulling on ear
● Irritability, “acting out”, malaise, poor feeding
● Bulging of the tympanic membrane on otoscopy
● Middle ear effusion
■ OME - otitis media with effusion
● Difficulty hearing or responding as expected to sounds
● Evidence of fluid in the middle ear without inflammation
● No infection
○ Treatment: pg. 1130
■ AOM
● Preferred drug is amoxicillin if not allergic
■ OME
● Evaluated periodically to be sure there is not an additional AOM that
needs treatment. Should improve within 3 months.
● If hearing is abnormal, speech testing should be performed
■ If infection recurs in spite of antibiotic treatment, myringotomy (surgical incision
of the tympanic membrane) may be performed and tympanostomy tubes
(pressure equalizing tubes) may be inserted
● Drink fluids, re-establish regular diet, give acetaminophen as ordered for
pain, place drops in ears if prescribed and restrict to quiet activities. No
dunking of head in the bath or swimming.
● Tubes typically fall out on their own in 1 year.
● What is nasopharyngitis and how is it treated? pg. 1139
○ URI; The common cold. Inflammation and infection of the nose and throat and is a
common illness of infancy and childhood.
○ Most frequently occurring bacterium is group A Streptococcus.
○ Symptoms:
■ Red nasal mucosa and clear discharge
■ Infected throat with enlarged tonsils
■ Vesicles may be present on the soft palate and in the pharynx
○ Treatment:
, ■ Dimetapp is normally used. Do not use more than 4-5 days.
■ Acetaminophen is given for fever.
■ Children over 6 can use nasal sprays. Should not be used more than 4-5 days.
■ Antihistamines may be helpful for children with allergic rhinitis or profuse
drainage.
■ Infants:
● If they cannot breathe through the mouth, saline nose drops can be
administered every 3-4 hours, especially before feeding, and followed by
bulb suctioning.
● Over 9 months, can be treated with normal saline.
● Do not use cough and cold products for children under 2 unless given
specific directions by a HCP.
● What is strep throat?
○ Bacterial pharyngitis. Most cases are caused by group A Streptococcus
○ Symptoms:
■ Abrupt onset
■ Throat redness and tonsillar exudate
■ Sore throat
■ Purulent white drainage and white patches (although not always present in all
cases)
○ Dx made by throat culture through rapid strep tests
○ Treatment:
■ Oral penicillin over 10 days or long acting penicillin in one shot.
■ Erythromycin, azithromycin or clarithromycin may be given in the event of a
penicillin allergy.
○ Symptom management:
■ Acetaminophen for throat pain and reducing fever.
■ Relief through cool, nonacidic fluids and soft foods, ice chips, , or frozen juice
pops given frequently in small amounts facilitate swallowing and prevent
dehydration
■ Gargling with salt water, or spraying throat with salt water.
● What are the symptoms of tonsillitis and how is it treated? pg. 1141
○ Symptoms:
■ Frequent throat infections with breathing and swallowing difficulties
■ Persistent redness of the anterior pillars
■ Enlargement of the cervical lymph nodes
■ If breathing through mouth, may have dry and irritated mucous membranes
Pediatrics
● What are the symptoms of otitis media and how is it treated medically or surgically?
○ Symptoms: pg. 1128
■ AOM - acute otitis media (usually caused by infection)
● Acute onset of ear pain
● Screaming, pulling on ear
● Irritability, “acting out”, malaise, poor feeding
● Bulging of the tympanic membrane on otoscopy
● Middle ear effusion
■ OME - otitis media with effusion
● Difficulty hearing or responding as expected to sounds
● Evidence of fluid in the middle ear without inflammation
● No infection
○ Treatment: pg. 1130
■ AOM
● Preferred drug is amoxicillin if not allergic
■ OME
● Evaluated periodically to be sure there is not an additional AOM that
needs treatment. Should improve within 3 months.
● If hearing is abnormal, speech testing should be performed
■ If infection recurs in spite of antibiotic treatment, myringotomy (surgical incision
of the tympanic membrane) may be performed and tympanostomy tubes
(pressure equalizing tubes) may be inserted
● Drink fluids, re-establish regular diet, give acetaminophen as ordered for
pain, place drops in ears if prescribed and restrict to quiet activities. No
dunking of head in the bath or swimming.
● Tubes typically fall out on their own in 1 year.
● What is nasopharyngitis and how is it treated? pg. 1139
○ URI; The common cold. Inflammation and infection of the nose and throat and is a
common illness of infancy and childhood.
○ Most frequently occurring bacterium is group A Streptococcus.
○ Symptoms:
■ Red nasal mucosa and clear discharge
■ Infected throat with enlarged tonsils
■ Vesicles may be present on the soft palate and in the pharynx
○ Treatment:
, ■ Dimetapp is normally used. Do not use more than 4-5 days.
■ Acetaminophen is given for fever.
■ Children over 6 can use nasal sprays. Should not be used more than 4-5 days.
■ Antihistamines may be helpful for children with allergic rhinitis or profuse
drainage.
■ Infants:
● If they cannot breathe through the mouth, saline nose drops can be
administered every 3-4 hours, especially before feeding, and followed by
bulb suctioning.
● Over 9 months, can be treated with normal saline.
● Do not use cough and cold products for children under 2 unless given
specific directions by a HCP.
● What is strep throat?
○ Bacterial pharyngitis. Most cases are caused by group A Streptococcus
○ Symptoms:
■ Abrupt onset
■ Throat redness and tonsillar exudate
■ Sore throat
■ Purulent white drainage and white patches (although not always present in all
cases)
○ Dx made by throat culture through rapid strep tests
○ Treatment:
■ Oral penicillin over 10 days or long acting penicillin in one shot.
■ Erythromycin, azithromycin or clarithromycin may be given in the event of a
penicillin allergy.
○ Symptom management:
■ Acetaminophen for throat pain and reducing fever.
■ Relief through cool, nonacidic fluids and soft foods, ice chips, , or frozen juice
pops given frequently in small amounts facilitate swallowing and prevent
dehydration
■ Gargling with salt water, or spraying throat with salt water.
● What are the symptoms of tonsillitis and how is it treated? pg. 1141
○ Symptoms:
■ Frequent throat infections with breathing and swallowing difficulties
■ Persistent redness of the anterior pillars
■ Enlargement of the cervical lymph nodes
■ If breathing through mouth, may have dry and irritated mucous membranes
