Final Exam: NR569/ NR 569 (Latest 2023/ 2024 Update) Differential Diagnosis in Acute Care Practicum Exam Review| 100% Correct- Chamberlain

Final Exam: NR569/ NR 569 (Latest 2023/

2024 Update) Differential Diagnosis in Acute

Care Practicum Exam Review| 100%

Correct- Chamberlain

Q: How is acute otitis media diagnosed?

Answer:

clinical presentation

objective findings on physical exam (otoscopy) combined with the patient's history and

presenting signs and symptoms

Q: Management of acute otitis media

Answer:

-the goal of treatment is to control pain and to treat the infectious process with antibiotics

-Adults with AOM should be treated with antibiotics: first line agent is amoxicillin/clavulanate

-Recurrent cases that do not resolve despite treatment may need referral to otolaryngologist

Q: first line treatment for acute otitis media

Answer:

amoxicillin 875 mg with clavulanate 125 mg orally twice daily.

mild to moderate: five to seven days

severe: 10 days

Q: otitis media with effusion

Answer:

presence of fluid in the middle ear without symptoms of acute infection.

As fluid builds up in the middle ear and Eustachian tube, it places pressure on the tympanic

membrane

Q: precipitating factors of otitis media w/ effusion

Answer:

URI

Q: Symptoms of otitis media w/ effusion

Answer:

hearing loss,

ear fullness,

complain of communication difficulties,

withdrawal, and lack of attention,

intermittent otalgia,

popping sensation of the ear

Q: Management of otitis media w/ effusion

Answer:

-Otitis media with effusion generally resolves spontaneously with watchful waiting.

-However, if it is persistent, myringotomy with tympanostomy tube insertion is considered an

effective treatment.

Q: Acute Otitis Externa (AOE)

Answer:

is an inflammation, that can be either infectious or non-infectious, of the external auditory canal.

"Swimmers ear"

Q: symptoms of Acute Otitis Externa (AOE)

Answer:

complain of pruritus and ear pain that is usually worse with manipulation of the tragus, pinna, or

both. It can also present with otorrhea, fullness sensation, and hearing loss.

Q: Severity scale: Acute Otitis Externa (AOE)

Answer:

-Mild: pruritus, mild discomfort, and ear canal edema

-Moderate: ear canal is partially occluded

-Severe: The external ear canal is completely occluded from edema. There is usually intense

pain, lymphadenopathy, and fever.

Q: Physical exam of Acute Otitis Externa (AOE)

Answer:

Otoscopy will reveal an erythematous and edematous ear canal with associated debris (yellow,

white, or gray).

Q: Treatment of Acute Otitis Externa (AOE)

Answer:

Topical antibiotics are the treatment of choice for AOE, with or without steroids

Topical antibiotics are the preferred therapy because a higher concentration of the antimicrobial

can be delivered to the infected tissue than systemic antibiotics

An ear wick may be inserted in the ear to facilitate installation of antibiotic drops in a tight canal

Systemic antibiotics are not indicated unless the patient also has a co-existing AOM infection

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