1229 Exam 6: Otitis Media

Question 1

4 Different sets of Tonsils

Answer 1

Pharyngeal Tonsil
Tubal Tonsil
Palatine Tonsil
Lingual Tonsil

Question 2

Functions of Tonsils

Answer 2

filter pathogens, antibody formation, they are larger in children for protection, smaller in adolescence and adult

Question 3

Tonsillectomy

Answer 3

is the removal of the palatine tonsils

Question 4

Tonsillectomy and Adenoidectomy

Answer 4

the removal of tonsils and adenoids

Question 5

Tonsillitis

Answer 5

inflammation of the tonsils

Question 6

Causes of Tonsillitis

Answer 6

Can be bacterial or viral
Bacterial-swollen uvula, whitish spots, red swollen tonsils, throat redness, gray furry tongue
Viral-red swollen tonsils, throat redness

Question 7

Pharyngitis

Answer 7

gradual onset, low-grade fever, rhinitis, cough, hoarseness occur after 1-2 days of fever, erythema of pharynx, tonsil enlargement, firm tender cervical lymph, Moderately ill 1-5 days Viral

Question 8

Bacterial Pharyngitis (Tonsillitis, Streptococcal (GABHS) )

Answer 8

Abrupt onset, fever 104, acute onset, severe sore throat, abd pain, white exudate pharynx and tonsils, erythema, tonsil enlargement, tender cervical lymph nodes, acutely ill up to 2 weeks

Question 9

Nur Considerations in Tonsillitis

Answer 9

comfort, soft liq diet, cool mist humidifier, warm salt water to gargle, throat lozenges, analgesic and antipyretic

Question 10

Surgical

Answer 10

Indications-massive hypertrophy, inflammation, malignancy, airway obstruction
Adenoidectomy- follow up with hearing, speech and taste
Contraindications-cleft palate, acute inflammation, blood dyscrasias, after age 4

Question 11

Prior to Surgery

Answer 11

History, Lab work, V/S, symptoms of URI, loose teeth, pysch support

Question 12

Post Op

Answer 12

side lying, careful suctioning, prevent bleeding(no coughing, clearing throat or blowing nose), inspect vomit, throat sore, ice collar, pain med, offer liquid or soft foods, watch for post op hemorrhage

Question 13

Discharge Teaching

Answer 13

Fluid Replacement, foods soft and non spicy, watch for hemorrhage, tachycardia, pallor, frequent throat clearing or swallowing, vomiting bright red blood, limit activities, pain control
Notify MD if severe earache, fever or cough,
Can hemorrhage up to 10 days post op

Question 14

Otitis Media

Answer 14

middle ear infection

age:6mo - 2 yr, preschool boys, large households, smoker, day care, bottle fed

Question 15

Causes of Otitis Media

Answer 15

Viral: RSV and Flu
Bacterial: strep, influenza, morzxella
Non infections OM from blockage

Question 16

Patho

Answer 16

swelling and blocking of eustachian tube, dysfunctioning eustachian tube

Question 17

ET tube functions

Answer 17

protection, drainage, and ventilation

Question 18

Acute OM s/s

Answer 18

irritable, pull ears, roll head side to side, high temp 104, bulging red tympanic membrane, rhinorrhea, vomiting, diarrhea, loss of appetite, rupture of tympanic membranes

Question 19

Nur considerations of OM

Answer 19

analgesics, antipyretics, topical pain relief drops, external application of heat or cold

Question 20

Meds for OM

Answer 20

antibiotics- amoxicillin, azithromycin, cephalosporins, IM ceftriaxone

Question 21

Definition OM w/ Effusion

Answer 21

fluid in the inner ear space with s/s of infection

Question 22

Causes of OM w/ Effusion

Answer 22

inflamed and enlarged adenoids, blockage of ET tube

Question 23

Complications of OM w/ Effusion

Answer 23

hearing loss, pain, and ruptured tympanic membrane

Question 24

S/S of OM w/ Effusion

Answer 24

exudate, pressure, possible tympanic membrane rupture, fullness in ear, popping when swallow, feeling of motion in ear, fluid in persist in middle ear for weeks to months, will have some hearing impairment

Question 25

Goal Therapy of OM w/ Effusion

Answer 25

establish/maintain aerated middle ear free of fluid and achieve normal hearing

Question 26

Why tubes?

Answer 26

a small incision is made in the tympanic membrane, tube inserted drains fluid, an ear infection with fluid behind tympanic membrane

Question 27

Otitis Externa

Answer 27

inflammation of the external ear and infection in ear canal, ear pain, best management is to prevent dirt or objects into ear canal, teach to put nothing smaller than elbow in ear canal