what time of year do most ear infections (Otitis Media) occur?
winter months
what are some environmental factors that could contribute to OM?
smokers in house, living with a lot of people, just had RSV or flu.socioeconomic status.
infants who are breast fed have a lower incidence of getting OM. t or f?
TRUE
an inflammation of the middle ear space with a rapid onset of s&s. fever and ear pain. bulging tympanic membrane.
acute otitis media (AOM)
an inflammation of middle ear. no pain or fever. rhinitis. cough. diarrhea may be present.
Otitis Media (OM)
fluid in the middle ear without s&s of acute infection. air bubbles.
Otitis Media with effusion (OME)
what is the clinical term for "earache
ostalgia
what signs would you see in an older child who has had chronic ear infections throught life?
maybe some hearing loss, tinnitus, difficulty communicating/speech issues
under what age should the child always be treated for OM?
under 6 months bc of immune system cannot fight yet
what would you give for an ear infection that wont clear?
Rocefin injection
what are some common antibx tx's for OM?
Amoxicillin or Omnicef
how long should you wait after the onset of OM before giving antibx?
72 hours as long as they are over 6mo
during the 72 hours you are waiting to give antibx for OM, what should you do for pain?
Tylenol AND motrin
the watchful waiting approach for children under age 2 is not recommended if they are showing signs of ear pain/OM. t or f?
TRUE
what is myringotomy?
surgical incision to relieve pressure on ear drum from pus/infection. provides drainage.
what do tubes do for ear infections?
allows for drainage of fluid. which promotes hearing and prevents scar formation
what is the principal cause of mono?
Epstein Barr virus
early signs of Mono?
HA, malaise, fatigue, chills, low grade fever, loss of appetite
why should a teenage who just recieved the dx of mono not play contact sports?
cannot play contact sports for 2 to 3 months because of risk of rupturing the spleen
what is the test for determining Mono?
blood test (spot test or Mono spot)
what type of tx is given for mono?
no specific tx. symptomatic, rest.
how long does mono fatigue usually last?
2 to 4 weeks
characterized by hoarsing, barking cough. inspiratory stridor and varying resp distress.
croup
croup can affect what parts of the body?
larnyx trachea and bronchi
what is the most common cause of croup?
viruses
steeple sign and swollen airway are associated with wht?
Croup
sore throat, pain, tripod pos, retractions, inspiratory stridor, swelling of epiglottis, mild hypoxia, chin out, mouth open, protruding tongue, drooling of saliva bc swallowng hurts
acute epiglottis
what is the therapeutic managment for these pts with epiglottis swelling?
mechanical intubation
what should you never do with a child that has suspected acute epiglottis?
Check the childs throat with a tongue depressor unless they are mechanically intubated
what are the 3 clinical observations that are predictable of acute epiglottis?
spontaneous cough, drooling, agitation
what is the tx for acute epiglottis?
humidified epinephrine
what is the tx for acute laryngitis?
fluids, humidified air
what is the chief complaint for acute laryngitis?
hoarseness
what is the most common of the croup syndromes?
(LTB) laryngotracheobronchitis
LTB generally affects which age group?
less than 5yo
gradual onset of low-grade fever, and the parents often report that the child went to bed and later awoke with a barky, brassy cough. Inflammation of the mucosa lining the larynx and trachea causes a narrowing of the airway. When the airway is significant
LTB
classic barking or seal-like cough and acute stridor after several days of rhinitis.
LTB
what is the main tx for LTB stage II and up?
Nebulizer treatments of Epi or steroids
what is the most important nursing function for pt with LTB?
continuous, vigilant observation and accurate assessment of respiratory status
acute spasmodic laryngitis happens when?
at night aka midnight croup
what is the tx for acute spasmodic laryngitis?
steroids PO, shower steam, night air thats cool
what is infection of the mucosa of the upper trachea?
bacterial tracheitis
thick, purulent, tracheal secretions is assoc with what infection?
bacterial tracheitis
what is the tx for bacterial tracheitis?
antipyretics, antibx, could require intubation, humidified o2
a 4yr comes to the ED with sore throat, difficulty swallowing, and suspected dx of epiglottis. your initial assessment should NOT include what?
throat culture
what is the causative agent of bronchitis?
viral
CM's dry hacking cough, worse at night, become productive in 2 to 3 days. Treatment is symptomatic.
Bronchitis
most common reason for infant hospitalization for infants under 1yr
RSV
how do you diagnose RSV?
nasal swab
what is the tx for RSV?
symptom management
do you give albuterol or steroids to RSV pt?
NO
what does Palivizumab do?
given monthly to infants as prohylaxis of RSV in high risk infants only.
rhinnorrhea, low grade fever, maybe some conjucitvitis, irritability, and maybe some resp distress signs
RSV
with bacterial pneumonia, what is the tx?
antibx
with bacterial pneumonia what does child appear like?
very ill, fever, malaise, cough, chest pain
what is the tx of viral pneumonia?
symptomatic
how do we treat pneumonia caused by mycoplasma bacteria?
Zithromax or cephlosporin in school age child
what is education to send home with parents for care of pneumonia?
antibx if necessary, antipyretics, fluids, bed rest, antitussives, contact isolation.