NURS 629 Exam 3 (Maryville) Complete and Updated Study Guide | Latest 2023/2024 solutions

NURS 629 Exam 3 (Maryville) Complete and Updated Study Guide | Latest 2023/2024 solutions Otitis media pathogens - Caused by: S. Pneumoniae (most common); H. Influenzae, M. Catarrhils Otitis media Symptoms: - Fever, Pain, discharge from ear, tugging at ear, irritability, crying, lethargy, decreased appetite, decreased sleep, Recent URI Objective findings in otitis media - 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 - Amoxicillin-clavulanate 80-90 mg/kg/day BID x 10 days Treatment for AOM d/t S. Pneumoniae (most common): - Amoxicillin 80-90 mg/kg/day BID x 10 days (high dose) Treatment for AOM with PCN Allergy: Non-Type 1: - Cefdinir, Cefuroxime Treatment for AOM with PCN Allergy: Type 1: - Azithromycin, clarithromycin OR Ceftriaxone 1-3 days Predisposing factors of otitis externa: - Frequent moisture, local trauma, aggressive cleaning, Allergies/skin conditions Causative organisms for otitis externa: - Psuedomonas aeruginosa (20-60%); Staphylococcus Aureus (10-70%); 10% fungal infection Symptoms of otitis externa: - 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: - 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: - Warm compresses, Auralgan, prednisone, Tylenol/ibuprofen, Wick (abx applied to wick ) When to wick with otitis externa: - If lumen is reduced to >50%, wicks can help ensure delivery of topical abx to medial canal. Treatment of otitis externa: - Topical fluroquinolones (Ciprofloxacin, Ofloxacin), ibuprofen and apap for pain, neomycin/polymixin b/hydrocortison otic (antibiotic/steroid) Hallmark sign of otitis externa: - Traction of pinna elicits pain When do we begin hearing tests in clinic for children - 4 years old What is a normal audiology test result and how are results read - 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 - Obesity, Diabetes, Hypertension, Family history: Coronary heart disease prior to age 55, Hyperlipidemia, Diabetes Clinical findings for tetralogy of Fallot: - 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 - 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 - • Vision is 20/400 • Fix and follow objects Viral conjunctivitis etiology (causative agent): - Adenovirus is the most common cause. Other causes: HSV, herpes zoster, and varicella Viral conjunctivitis symptoms: - 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 - 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: - Symptomatic Only - Warm or cool compresses, Strict hand hygiene Pharyngitis - Typically viral Causative organism for bacterial pharyngitis - Group A Beta Hemolytic strep