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34 Cards in this Set
- Front
- Back
Otitis Media
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effusion and infection or blockage of the middle ear with or with out infection
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otalgia
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ear pain
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Otitis Media with Effusion
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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
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Otitis Media Etiology
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S. pneumonia
H. influenzae M. catarrhalis |
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OM pathophysiology
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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 |
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Signs & Symptoms
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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 |
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OM Therapeutic Management
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Symptomatic treatment & observation
Delayed antibiotic treatment Myringotomy & PE Tubes |
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OM Nursing Care
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Acute pain
Infection Knowledge deficit Risk for delay in growth & development |
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OM Teaching
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• 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 |
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Patient Teaching for PE tubes
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• 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) |
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Pharyngitis/Tonsillitis Etiology
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Can be viral or bacterial in nature
Group A beta hemolytic streptococcal bacteria - most common causative agent |
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Pharyngitis/Tonsillitis Pathophysiology
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• 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 |
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Pharyngitis/Tonsillitis Signs & Symptoms
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• 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 |
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Pharyngitis/Tonsillitis Therapeutic Management
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• Diagnosis by visual inspection & S&S
• Rapid strep test & throat culture • Oral antibiotics for + strep • Symptomatic treatment • Tonsillectomy |
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Pharyngitis/Tonsillitis Nursing Care
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• 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 |
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Pharyngitis/Tonsillitis Teaching
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• 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 |
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Croup
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Group of conditions characterized by:
– Inspiratory stridor, barky/croupy cough, cough, hoarseness, & resp. distress |
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Croup Clinical Manifestations
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• 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 |
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Mild Croup Treatment
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• Humidification
• Observation at home • Corticosteroids (dexamethasone) |
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Severe Croup Treatment
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• Hospital admission
• Oxygen with high humidity • Albuterol • Racemic epinephrine or IV steroids may be used • Possible intubation |
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Epiglottitis
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Acute inflammation & swelling of the
epiglottis & surrounding tissues |
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Epiglottitis Etiology
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H. influenzae
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Epiglottitis Sign and Symptoms
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• 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 |
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Epiglottitis Cardinal Signs
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4 D's
• Drooling • Dysphagia • Dysphonia • Distressed inspiratory effort (stridor) |
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Bronchiolitis
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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 |
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Bronchiolitis Pathophysiology
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• 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 |
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Bronchiolitis Therapeutic Management
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• Mild treated at home – fluids,
humidification, and rest • Respiratory distress – hospitalized for supportive treatment – Humidified oxygen, IV Fluids |
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Bronchiolitis Medication
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– Bronchodilators
– Corticosteroids – Epinephrine |
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Bronchiolitis Nursing Care
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-facilitate gas exchange
-prevent transmission -maintain hydration -reduce fever |
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Asthma Etiology
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environmental, viral, allergens, genetic predisposition
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Asthma Sign & Symptoms
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• Cough
• Wheezing • Dyspnea • Use of accessory muscles / retractions • Tachypnea • Nasal Flaring |
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Acute Asthma Treatment
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• Medications
• Oxygen • Hydration • Rest |
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Asthma Long-term Treatment
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minimize and control symptoms
prevent acute episodes avoid side effects of therapy normal lifestyle for the child |
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Asthma Nursing Care
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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 |