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Flashcards in Exam 2 Deck (115)
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1

What are the recommended therapies for small children with nasopharyngitis?

Supportive tx with antipyretics, nasal saline irrigation, and adequate fluid hydration. Elevating HOB to drain secretions and suctioning with a bulb syringe.

2

Why shouldn't cough suppressants be used for nasopharyngitis?

Because cough is a protective way to clear secretions. They may be prescribed for a dry hacking cough at night.

3

What do you teach families about URIs?

They usually resolve within 4-10 days. They're frequent in children younger than 3 and by 5 their children will have developed immunity to many viruses.

4

What causes strep throat?

Group A Beta-Hemolytic Streptococcus

5

Children with strep throat are at risk for what for 10 days?

Acute glomerulonephritis

6

Children with strep throat are at risk for what for 18 days?

Acute rheumatic fever

7

Incubation period for strep throat

2-4 days

8

When does strep throat usually subside?

3-5 days

9

How is strep throat treated?

With oral penicillin for 10 days or IM Pen G (very painful, can cause local skin reactions or rash)

10

How to care for tonsillectomy patient

Placed on side or abdomen to facilitate drainage, suction cautiously, ice collar to provide relief, prevent coughing/crying/blowing nose

11

Signs of airway obstruction after tonsillectomy

Stridor, drooling, restlessness

12

Where is dark brown blood usually found after a tonsillectomy?

Nose, emesis, teeth

13

Diet for post-tonsillectomy

No fluids with red or brown color, avoid citrus, need soft or liquid diet

14

Signs of post-op bleeding after tonsillectomy

High HR, frequent clearing of throat or swallowing, vomiting bright red blood

15

How long will pts have bad breath after a tonsillectomy?

5-10 days

16

Highest incidence of otitis media

Ages 6-20 months and in winter months

17

Bacterial OM is usually preceded by what?

A viral respiratory infection (RSV, Influenza)

18

What causes OM?

Malfunctioning eustachian tube. Obstruction of tube causes accumulation of secretions
Can eventually produce an effusion

19

Acute OM

Visual inspection shows a purulent
discolored effusion and a bulging
reddened membrane, abrupt onset

20

OM with effusion

Inflammation and fluid in the middle ear without s/s of acute infection
- immobile membrane or orange discolored
membrane
Symptoms may be absent, nonspecific
symptoms present (rhinitis, cough, diarrhea)

21

When do pts need hearing evaluations with OM effusion?

Every 3-6 months until resolved

22

When are antibiotics given for OM?

Less than 6 months, severe s/s of AOM (ear pain for at least 48 hours or temp >102.2F), bilateral AOM without s/s,

23

Tx for unilateral AOM without severe s/s & for 24 months without s/s

Either give abx or watch for 48-72 hours for improvement

24

Tx of OME

Abx given if fluid present for > 3mo

25

What is IM Rocephin for with OM?

Highly resistant bacteria or noncompliance

26

What is the abx of choice for OM?

Amoxicillin for 10 days (n/v, diarrhea)
Do not give if have PCN allergy
Other abx – augmentin, azithromycin, cephalosporin

27

Myringotomy

Surgical incision of eardrum to provide drainage and relieve pain

28

Tympanostomy tube placement

Tx recurrent chronic AOM (3 bouts in 6 mo, 6 in 12 mo, 6 by 6 years old)

29

Nursing care after a tympanostomy tube placement

Facilitate continued drainage of fluid and allow ventilation of middle ear

30

Prevention of OM

Pneumococcal vaccine (PCV7), annual flu vaccine
reduce risk factors - breast feed for at least 6 mo, avoid propping bottle, decrease pacifier use after 6 months, avoid exposure to tobacco smoke