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?
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?
