(MVU)NURS 629 Exam 3 *SOLVED*
Otitis media - correct answer #1 diagnosis is among healthcare providers caring for
children
-By the age of 3, 2/3 of all children will have had an OM: ½ will have >3 occurrences
OM is most common in - correct answer boys, first born, winter months, bottle fed
babies, preemies, daycare children, achildren aof asmokers
Reason afor aOM a- acorrect aanswer a■ aEustachian atube ais ashorter. aBy athe aages a7-12
athe aeustachian atube aresembles athat aof aan aadult
■ aAdenoids acan abe aenlarged. aIf athe aadenoid athat ais aenlarged ad/t asmaller anasal
acanals a& arespiratory atract, athat acan aeasily ablock athe aeustachian atube a& anot aallow
afor adrainage
Common abacterial acauses afor aOM? a- acorrect aanswer a● aS. apneumoniae: amost
acommon
● aH. ainfluenzae: achild apresents awith aconjunctivitis awith aOM, atreat awith aAugmentin
aand atopical aantibiotic afor aconjunctivitis
● aM. acatarrhalis
Symptoms aof aOM? a- acorrect aanswer a■ aFever, apain, adischarge afrom athe aear,
atugging aor abatting aat athe aear, airritability, acrying, alethargy, adecreased aappetite,
adecreased asleep, arecent aURI
Clinical aSigns aof aOM? a- acorrect aanswer a■ aRed, abulging aTM, aretracted awith apus,
adecreased atranslucency aof aTM, ano amovement aof athe aTM, ainability ato asee anormal
alandmarks, aoccasionally: ahole ain athe aTM
Diagnosis aof aOM arequirements? a- acorrect aanswer a■ aHistory aof aacute aonset
■ aIdentify apresence aof amiddle aear aeffusion: abulging aTM, adecreased aor aabsent
amobility aof aTM, aamber afluid aor aappearance aof aTM, aotorrhea
■ aIdentify asigns aof amiddle aear ainflammation: aerythematous aTM, aotalgia a(which
ainterferes awith afunction/sleep)
Tx aof aOM? aages: a
>6m
6m-2yrs
>2yrs a- acorrect aanswer a<6m: aabx aif acertain aor anot
6-12m: aabx aif a: afever a>102, abilateral ainfection, asevere aotalgia, alonger athan a7 adays
a(observe aif anot asevere)
>2 ayrs: aabx aif asevere a^ aobserve aif anot
Symptoms arelief afor aOM? a(non-abx) a- acorrect aanswer a● aAcetaminophen aor
aibuprofen: amild ato amoderate apain
,● aBenzocaine a(Auralgan, aAmerciaine aotic): amild ato amoderate apain
● aWarm acompress
ABX atx afor aOM? a- acorrect aanswer a● aClinically adefined atreatment afailure aat a48-72
ahours aafter ainitial amanagement awith aobservation aor aat adiagnosis afor apatients
abeing ainitially awith aantibacterial aagents
ABX: a
Amoxicillin a80-90 amg/kg/day aBID afor a10 adays a
OR aIF aPCN aALLERGY: a
Non-Type a1: aCefdinir, acefuroxime
Type a1: aAzithromycin, aclarithromycin
OR: aSEVERE aOM: a
Augmentin a(Amoxicillin-clavulanate) a80-90 amg/kg/day afor a10 adays aor a
PCN aalg: aCeftriaxone a1 aor a3 adays
Signs aof abacterial aAOM? a- acorrect aanswer a• aBulging aTM awith adecreased amobility,
aacute aonset apain aand afever
when ado ayou anot a'watch aand await' aon aAOM? a- acorrect aanswer ao aKids ayounger
athan a6 amonths
o a\Children a6 amo a- a2 ayears awith amoderate ato asevere apain a(concerned abc aof
aspeech adevelopment aduring athis atime)
o a2 aand aolder awith ahigh afever a
o aAll achildren awith acomorbidities asuch aas aheart adisease aetc
How ado ayou atreat aAOM ain akid awho ahas aear atubes? a- acorrect aanswer
aOfloxacin/cipro agtt
If apt adevelops arash aafter ataking aamox afor aear ainfection awhat ado ayou ado? a-
acorrect aanswer astop aand astart acephalosporin
What aare athe apredisposing afactors afor aotitis aexterna? a- acorrect aanswer a■ aFrequent
aexposure ato amoisture aof athe aear
■ aAggressive acleaning aof athe aear acanal a(do anot ause aQ-tips abecause athat acan
acause alittle amicro atears ain athe askin awhich acan alead ato ainflammation aand ainfection)
■ aLocal atrauma ato athe aear
■ aAllergies a& askin aconditions
■ aEczema
t/f aotitis aexterna ais atypically abilateral? a- acorrect aanswer aF ausually aunilateral
symptoms aof aotitis aexterna? a- acorrect aanswer a■ aDischarge afrom athe aear
a(especially aif athe aTM ahas arupture), alow agrade afever, arecent ahistory aof aswimming
, aor aplacing asomething ain aear, apain awith amovement aof athe atragus, aredness aaround
aear, adecreased ahearing
tx aof aotitis aexterna? a- acorrect aanswer a■ aTopical aantimicrobial afor ainitial atherapy aof
adiffuse aAOE ashould abe abased aupon aefficacy, alow aincidence aof aadverse aevents,
alikelihood aof aadherence ato atherapy, aand acost. a
■ aPain amanagement: aanalgesic atreatment abased aon athe aseverity aof apain
■ aTherapeutic
● aWarm acompresses, aNSAIDs/Tylenol, aprednisone, aauralgan, aOTC abenzocaine
adrops aand athen awicking
when ashould apt awith aotitis aexterna areturn aif atherapy ahas afailed? a- acorrect aanswer
a■ aIf athe apatient afails ato arespond ato athe ainitial atherapeutic aoption awithin a48-72
ahours, athe aclinician ashould areassess athe apatient ato aconfirm athe adiagnosis aof
adiffuse aAOE aand ato aexclude aother acauses aof aillness
what aare ared aflag asymptoms aof athroat apain? a- acorrect aanswer adrooling, astridor, aor
atrouble abreathing
Do aNOT aexamine
What atype aof arash ais aassociated awith astrep? a- acorrect aanswer asandpaper arash
what aare acommon acomplications aof apharyngitis? a- acorrect aanswer aperitonsillar
aabscesses, arheumatic afever, apost-streptococcal, aglomerulonephritis
What aare athe acommon asigns/symptoms aof aGroup aAB astrep? a- acorrect aanswer a■
aSymptoms: arapid aonset aof asore athroat, afever a103-104, aswollen aglands, achildren
aoften acomplain aof aabdominal apain, ausually ano aURI asymptoms, aheadache,
adecreased aappetite, adysphagia, airritability
■ aSigns: aexudate atonsils, aanterior acervical alymphadenopathy, astrawberry atongue,
arash
Diagnostic afor astrep? a- acorrect aanswer a■ aThroat aculture: a24 ahr ais athe agold
astandard, amust aswab aboth atonsils afor abest aresults
■ aRemember a50% aof akids awith amono aalso ahave astrep
what ais athe acommon aabx afor astrep? a- acorrect aanswer a■ aAmoxicillin a(50-80
amg/kg/day) ax a10 adays a(PCN aallergy: acephalosporin aor amacrolide)
■ aWarm awater agargles
■ aTylenol/NSAIDs
What acauses aMono? a- acorrect aanswer aEpstein-Barr avirus
what ais athe aclassic amono atriad? a- acorrect aanswer a: afever, aexudative apharyngitis,
aadenopathy a(posterior acervical)
Otitis media - correct answer #1 diagnosis is among healthcare providers caring for
children
-By the age of 3, 2/3 of all children will have had an OM: ½ will have >3 occurrences
OM is most common in - correct answer boys, first born, winter months, bottle fed
babies, preemies, daycare children, achildren aof asmokers
Reason afor aOM a- acorrect aanswer a■ aEustachian atube ais ashorter. aBy athe aages a7-12
athe aeustachian atube aresembles athat aof aan aadult
■ aAdenoids acan abe aenlarged. aIf athe aadenoid athat ais aenlarged ad/t asmaller anasal
acanals a& arespiratory atract, athat acan aeasily ablock athe aeustachian atube a& anot aallow
afor adrainage
Common abacterial acauses afor aOM? a- acorrect aanswer a● aS. apneumoniae: amost
acommon
● aH. ainfluenzae: achild apresents awith aconjunctivitis awith aOM, atreat awith aAugmentin
aand atopical aantibiotic afor aconjunctivitis
● aM. acatarrhalis
Symptoms aof aOM? a- acorrect aanswer a■ aFever, apain, adischarge afrom athe aear,
atugging aor abatting aat athe aear, airritability, acrying, alethargy, adecreased aappetite,
adecreased asleep, arecent aURI
Clinical aSigns aof aOM? a- acorrect aanswer a■ aRed, abulging aTM, aretracted awith apus,
adecreased atranslucency aof aTM, ano amovement aof athe aTM, ainability ato asee anormal
alandmarks, aoccasionally: ahole ain athe aTM
Diagnosis aof aOM arequirements? a- acorrect aanswer a■ aHistory aof aacute aonset
■ aIdentify apresence aof amiddle aear aeffusion: abulging aTM, adecreased aor aabsent
amobility aof aTM, aamber afluid aor aappearance aof aTM, aotorrhea
■ aIdentify asigns aof amiddle aear ainflammation: aerythematous aTM, aotalgia a(which
ainterferes awith afunction/sleep)
Tx aof aOM? aages: a
>6m
6m-2yrs
>2yrs a- acorrect aanswer a<6m: aabx aif acertain aor anot
6-12m: aabx aif a: afever a>102, abilateral ainfection, asevere aotalgia, alonger athan a7 adays
a(observe aif anot asevere)
>2 ayrs: aabx aif asevere a^ aobserve aif anot
Symptoms arelief afor aOM? a(non-abx) a- acorrect aanswer a● aAcetaminophen aor
aibuprofen: amild ato amoderate apain
,● aBenzocaine a(Auralgan, aAmerciaine aotic): amild ato amoderate apain
● aWarm acompress
ABX atx afor aOM? a- acorrect aanswer a● aClinically adefined atreatment afailure aat a48-72
ahours aafter ainitial amanagement awith aobservation aor aat adiagnosis afor apatients
abeing ainitially awith aantibacterial aagents
ABX: a
Amoxicillin a80-90 amg/kg/day aBID afor a10 adays a
OR aIF aPCN aALLERGY: a
Non-Type a1: aCefdinir, acefuroxime
Type a1: aAzithromycin, aclarithromycin
OR: aSEVERE aOM: a
Augmentin a(Amoxicillin-clavulanate) a80-90 amg/kg/day afor a10 adays aor a
PCN aalg: aCeftriaxone a1 aor a3 adays
Signs aof abacterial aAOM? a- acorrect aanswer a• aBulging aTM awith adecreased amobility,
aacute aonset apain aand afever
when ado ayou anot a'watch aand await' aon aAOM? a- acorrect aanswer ao aKids ayounger
athan a6 amonths
o a\Children a6 amo a- a2 ayears awith amoderate ato asevere apain a(concerned abc aof
aspeech adevelopment aduring athis atime)
o a2 aand aolder awith ahigh afever a
o aAll achildren awith acomorbidities asuch aas aheart adisease aetc
How ado ayou atreat aAOM ain akid awho ahas aear atubes? a- acorrect aanswer
aOfloxacin/cipro agtt
If apt adevelops arash aafter ataking aamox afor aear ainfection awhat ado ayou ado? a-
acorrect aanswer astop aand astart acephalosporin
What aare athe apredisposing afactors afor aotitis aexterna? a- acorrect aanswer a■ aFrequent
aexposure ato amoisture aof athe aear
■ aAggressive acleaning aof athe aear acanal a(do anot ause aQ-tips abecause athat acan
acause alittle amicro atears ain athe askin awhich acan alead ato ainflammation aand ainfection)
■ aLocal atrauma ato athe aear
■ aAllergies a& askin aconditions
■ aEczema
t/f aotitis aexterna ais atypically abilateral? a- acorrect aanswer aF ausually aunilateral
symptoms aof aotitis aexterna? a- acorrect aanswer a■ aDischarge afrom athe aear
a(especially aif athe aTM ahas arupture), alow agrade afever, arecent ahistory aof aswimming
, aor aplacing asomething ain aear, apain awith amovement aof athe atragus, aredness aaround
aear, adecreased ahearing
tx aof aotitis aexterna? a- acorrect aanswer a■ aTopical aantimicrobial afor ainitial atherapy aof
adiffuse aAOE ashould abe abased aupon aefficacy, alow aincidence aof aadverse aevents,
alikelihood aof aadherence ato atherapy, aand acost. a
■ aPain amanagement: aanalgesic atreatment abased aon athe aseverity aof apain
■ aTherapeutic
● aWarm acompresses, aNSAIDs/Tylenol, aprednisone, aauralgan, aOTC abenzocaine
adrops aand athen awicking
when ashould apt awith aotitis aexterna areturn aif atherapy ahas afailed? a- acorrect aanswer
a■ aIf athe apatient afails ato arespond ato athe ainitial atherapeutic aoption awithin a48-72
ahours, athe aclinician ashould areassess athe apatient ato aconfirm athe adiagnosis aof
adiffuse aAOE aand ato aexclude aother acauses aof aillness
what aare ared aflag asymptoms aof athroat apain? a- acorrect aanswer adrooling, astridor, aor
atrouble abreathing
Do aNOT aexamine
What atype aof arash ais aassociated awith astrep? a- acorrect aanswer asandpaper arash
what aare acommon acomplications aof apharyngitis? a- acorrect aanswer aperitonsillar
aabscesses, arheumatic afever, apost-streptococcal, aglomerulonephritis
What aare athe acommon asigns/symptoms aof aGroup aAB astrep? a- acorrect aanswer a■
aSymptoms: arapid aonset aof asore athroat, afever a103-104, aswollen aglands, achildren
aoften acomplain aof aabdominal apain, ausually ano aURI asymptoms, aheadache,
adecreased aappetite, adysphagia, airritability
■ aSigns: aexudate atonsils, aanterior acervical alymphadenopathy, astrawberry atongue,
arash
Diagnostic afor astrep? a- acorrect aanswer a■ aThroat aculture: a24 ahr ais athe agold
astandard, amust aswab aboth atonsils afor abest aresults
■ aRemember a50% aof akids awith amono aalso ahave astrep
what ais athe acommon aabx afor astrep? a- acorrect aanswer a■ aAmoxicillin a(50-80
amg/kg/day) ax a10 adays a(PCN aallergy: acephalosporin aor amacrolide)
■ aWarm awater agargles
■ aTylenol/NSAIDs
What acauses aMono? a- acorrect aanswer aEpstein-Barr avirus
what ais athe aclassic amono atriad? a- acorrect aanswer a: afever, aexudative apharyngitis,
aadenopathy a(posterior acervical)
