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| Explained| Practice| NURS 629 EXAM III (Questions And Answers)|

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  • September 13, 2022
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  • 2022/2023
  • Exam (elaborations)
  • Questions & answers
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NURS 629 EXAM 3 QUESTIONS
study guide
 What is otitis media?
 Inflammatory fluid and pathogenic respiratory bacteria that reflux into the middle ear
space- does not drain normally. 75% are viral infections
most common bacterial etiologic agents: streptococcus pneumoniae 49%, H influenzae
29%, Moraxella catarrhalis 28%
 What are the signs/symptoms of otitis media?
 fever, pain, d/c from ear, tugging/batting at ear, irritability, crying lethargy, decreased
appetite, decreased sleep, recent URI

Red, bulging TM, possible-retracted w/ pus, decreased translucency, no movement of
TM, no normal landmarks, hole in TM
 What is considered recurrent otitis media?
 3 or more in 6 months OR 4 in one year
 How do you treat otitis media in babies <6 months?
 antibiotics, no matter what
 How do you treat otitis media in children 6 months to 2 years?
o antibiotics if certain or severe symptoms like high fever, bilateral infections, severe pain, more
than 7 days; observe if not certain or not severe
 How do you treat otitis media in children 2 years or older?
o antibiotics if severe, observe 2-3 days if not severe
 What antibiotics do you use to treat otitis media?
o Amoxicillin 80-90 mg/kg/day BID x 10 days; Augmentin 80-90 mg/kg/day BID x 10 days;
if PCN allergy- cefdinir, cefuroxime- non type 1 reaction or if type 1 reaction then
azithromycin, clarithromycin, ceftriaxone
 What is otitis externa?
o inflammatory process that involves the structure of the outer ear, specifically the
external auditory canal

can be from trauma, glandular obstruction, repeating ear cleansing, prolonged
exposure to standing water, increased sweating, or stress
 What are the s/sx of otitis externa?
o tenderness of pinna or tragus, boggy canal
 What is the treatment for otitis externa?
o ototopical antimicrobial-steroid solution containing neomycin, polymyxin B, and
hydrocortisone 4x/day x 7-10 days

topical fluoroquinolone ciprofloxacin, ofloxacin
 What is malignant otitis externa?
o necrotizing, invasive infection of the external auditory canal

usually caused by P aeuginosa and can lead to osteomyelitis
 What is otitis media with effusion?

, o non-infected fluid in middle ear without s/sx of acute otitis media
 What is mononucleosis?
o caused by epstein-barr virus and spread by saliva; incubation of 2-5 weeks; 50% of kids with
mono also have strep

s/sx fever, exudative pharyngitis, POSTERIOR cervical adenopathy, malaise, headache,
anorexia, spleno/hepatomegaly
 How do you treat mono?
o symptomatic treatment, f/u in 1-2 weeks, avoid contact sports x 1 month or until
spleen no longer palpable
 What are symptoms of group A beta-hemolytic strep pharyngitis?
o rapid onset sore throat, fever 103-104, swollen glands, abdominal pain, usually no URI
symptoms, headache, decreased appetite, dysphagia, irritability

exudate tonsils, anterior cervical lymphadenopathy, strawberry tongue, rash
 How do you treat strep pharyngitis?
 Amoxicillin 50-80 mg/kg/day x 10 days, if PCN allergy- cephalosporins or
macrolide

warm water gargles, tylenol/nsaids

Contagious- no school x 24 hours, discard toothbrush
 What is impetigo?
o contagious bacterial infection caused by staphylococci or streptococci, spread by
contact

pruritic rash that won't go away, yellow-crusted lesions, if crust removed- becomes
inflammed/red
 How do you treat impetigo?
o wash face BID with soap and water, no school for 24-48 hours, wash sheets/pillow cases,
monitor for serous sequalae

treat with mupirocin/bactroban TID x 7-14 days or bacitracin TID x 7-14 days, or erythromycin,
cephalexin
 What is fifth's disease?
o caused by human parvovirus B19, most common in 5-15 yo; symptomatic treatment

has low-grade fever, malaise, sore throat, "slap cheek" facial redness in first 4 days,
then fishnet/racey rash within 2 days after initial onset, then fever/itching/petechiae to
hands/feet
 What is tinea corporis?
o ringworm- pink, scaly, round with raised border

treat with topical antifungal cream for 2-6 weeks, avoid contact with lesion, no contact
sports x 48 hrs of tx
 What is pityriasis rosea?

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