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34 Cards in this Set

  • Front
  • Back
Otitis Media
effusion and infection or blockage of the middle ear with or with out infection
otalgia
ear pain
Otitis Media with Effusion
the presence of fluid behind the tympanic membrane without signs of infection, often occurs after AOM and resolved over a period of 1-3 months
Otitis Media Etiology
S. pneumonia
H. influenzae
M. catarrhalis
OM pathophysiology
Normal Eustachian tube ventilates by opening to allow drainage of secretions produced by middle and to equalize air pressure between middle ear and outside environment.
Tube becomes blocked, secretions are retained, air that cant escape is absorbed causing a negative pressure
Signs & Symptoms
Otalgia
Irritable
tugging at ears or rolling head side to side
Bulging red tympanic membrane
Drainage
Sleep disturbances
Persistent crying
Fever
Vomiting, anorexia, & diarrhea
Cervical and post auricular node enlargement
OM Therapeutic Management
Symptomatic treatment & observation
Delayed antibiotic treatment
Myringotomy & PE Tubes
OM Nursing Care
Acute pain
Infection
Knowledge deficit
Risk for delay in growth & development
OM Teaching
• Importance of giving prescribed antibiotic on
time and for the prescribed # of days
• Provide parents with written and verbal
instruction on how to administer medications
• Acetaminophen for pain relief
• Importance of follow-up appt with
pediatrician
• Decrease risk for recurrent AOM
Patient Teaching for PE tubes
• No nose blowing 7-10 days
• Report ↑ bleeding, ↑ pain, fever
• Keep ears dry, use ear plugs
• No diving / swimming in deep water
• Notify MD when tubes fall out (6-12 months)
Pharyngitis/Tonsillitis Etiology
Can be viral or bacterial in nature

Group A beta hemolytic streptococcal
bacteria - most common causative agent
Pharyngitis/Tonsillitis Pathophysiology
• Peaks b/t 4 and 7 years of age
• More frequent is winter months
• Incidence decreases in middle childhood (12
yrs) as lymphoid tissue shrinks
Pharyngitis/Tonsillitis Signs & Symptoms
• Sore throat (persistent or recurrent)
• Enlarged tonsils - bright red w/ exudate
• Difficulty swallowing
• Mouth breathing – odor
• Enlarged adenoids
– voice has nasal and muffled quality
– mouth breathing, hearing diff, AOM, snoring,
obstructive sleep apnea
– peritonsillar abscess - older children
Pharyngitis/Tonsillitis Therapeutic Management
• Diagnosis by visual inspection & S&S
• Rapid strep test & throat culture
• Oral antibiotics for + strep
• Symptomatic treatment
• Tonsillectomy
Pharyngitis/Tonsillitis Nursing Care
• Acute pain r/t surgical removal of tonsils
• Risk for injury (hemorrhage) r/t surgical procedure
• Ineffective Airway Clearance r/t throat discomfort
• Risk for deficient fluid volume r/t diff swallowing
and NPO status pre-op
• Deficient knowledge related home care
Pharyngitis/Tonsillitis Teaching
• Quiet activities for 1 week
• Encourage fluid intake; NO RED liquids
• No straws
• 1st day clear liquids; 2nd day full liquids & soft foods
• Avoid rough scratchy, citrus, or spicy food for 3 weeks
• Analgesics for pain
• Discourage coughing, clearing throat
• Bad mouth odor normal, drink more
• Earache & slight fever normal
• R/T school 10 days
• F/U appt 1 to 2 weeks
Croup
Group of conditions characterized by:
– Inspiratory stridor, barky/croupy cough, cough,
hoarseness, & resp. distress
Croup Clinical Manifestations
• LTB gradual onset with fever
• Spasmodic croup no fever
• Harsh, sharp, barky cough
• Inspiratory stridor, hoarseness
• Use of accessory muscles (retractions)
• Looks frightened
• Agitated
• Cyanosis
Mild Croup Treatment
• Humidification
• Observation at home
• Corticosteroids (dexamethasone)
Severe Croup Treatment
• Hospital admission
• Oxygen with high humidity
• Albuterol
• Racemic epinephrine or IV steroids
may be used
• Possible intubation
Epiglottitis
Acute inflammation & swelling of the
epiglottis & surrounding tissues
Epiglottitis Etiology
H. influenzae
Epiglottitis Sign and Symptoms
• High fever
• Wake up with severe sore throat and diff.
swallowing
• Appears very ill/toxic
• Inspiratory stridor
• Respiratory distress can occur in a few hours
• Anxious, frightened, irritable, lethargic
Epiglottitis Cardinal Signs
4 D's
• Drooling
• Dysphagia
• Dysphonia
• Distressed inspiratory effort (stridor)
Bronchiolitis
The bronchioles become narrowed, some even totally
occluded, due to:
– inflammatory process,
– edema of the airway wall
– accumulation of mucus and cellular debris
– smooth muscle spasms
Bronchiolitis Pathophysiology
• There may be thickening of the muscular wall and destruction
of the ciliated cells
• The airway passage becomes obstructed.
• Narrowing of the lumen causes a profound decrease in airflow
with resultant trapping of air with expiration
Bronchiolitis Therapeutic Management
• Mild treated at home – fluids,
humidification, and rest
• Respiratory distress – hospitalized for
supportive treatment
– Humidified oxygen, IV Fluids
Bronchiolitis Medication
– Bronchodilators
– Corticosteroids
– Epinephrine
Bronchiolitis Nursing Care
-facilitate gas exchange
-prevent transmission
-maintain hydration
-reduce fever
Asthma Etiology
environmental, viral, allergens, genetic predisposition
Asthma Sign & Symptoms
• Cough
• Wheezing
• Dyspnea
• Use of accessory muscles / retractions
• Tachypnea
• Nasal Flaring
Acute Asthma Treatment
• Medications
• Oxygen
• Hydration
• Rest
Asthma Long-term Treatment
minimize and control symptoms
prevent acute episodes
avoid side effects of therapy
normal lifestyle for the child
Asthma Nursing Care
Ineffective airway clearance r/t bronchospasm mucosal edema
Impaired gas exchange r/t air tapping in the bronchioles
Activity Intolerance r/t fatigue and SOB
Deficient knowledge r/t disease process and treatment regimen