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Great post, especially in regards to the comprehensive guidance you would give to the parent. I believe that this sort of guidance is necessary because it empowers the parent and makes them feel that they are proactive with the care of their child. This will allow for more adherence to the guidance and lead to better health outcomes. Also, I agree with your diagnosis. It is often difficult to distinguish between your primary and differential diagnoses because they appear to be so similar. However, the subtle differences are what make the difference in the diagnosisBurns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (Eds.). (2017). Pediatric primary care(6th ed.). St. Louis, Missouri: Elsevier.REPLYQUOTE2 months ago
Gwenevere Harris RE: Week 4 Discussion - Case 1COLLAPSEEstela,Thanks for sharing your post. You made an interesting point of educating mom on symptoms thatworsen, and I agree with your diagnose. While AOM is common in children, it accounts for many doctor offices and Er visits. One study suggests 30% of children under 3 years of age visit their doctors each year due to AOM; whereas, 97% of these patients receive antibiotics (Damoiseaux & Rovers.,2011). One other important factor determined that AOM usually resolves in 24 hours in 60 percent of children and resolves in less than 3 days in approximately 80 percent (Damoiseaux et al., 2011). While overprescribing antibiotics have been an issue for many years; therefore, knowing when to prescribe has been the dilemma. Many pediatric providers are making difficult decisions about whether to prescribe antibiotics or observe instead. According to Frost, Becker, Knepper, Shihadeh, & Jenkins (2020) merely suggests, “Thus, understanding prescribing habits for AOM is critical to designing effective strategies to improve overall pediatric antibiotic use” (para.8). In fact, research has shown that approximately80 percent of AOM may spontaneously resolve, and inappropriate antibiotic prescribing leads to increases in bacterial resistance. ReferencesDamoiseaux, R. A., & Rovers, M. M. (2011). AOM in children. BMJ clinical evidence, 2011, 0301.Frost, H. M., Becker, L. F., Knepper, B. C., Shihadeh, K. C., & Jenkins, T. C. (2020). Antibiotic Prescribing Patterns for Acute Otitis Media for Children 2 Years and Older. The Journal of Pediatrics, 220, 109–115. -org.ezp.waldenulibrary.org/10.1016/j.jpeds.2020.01.045NP 6541: Primary Care of Adolescents and ChildrenAdditional Questions to AskWhen evaluating the third case study it is important to discuss the LOCATES. There are three parts of the LOCATES that I feel is missing. These include C) for the character, T) for treatment, E) for exacerbating or relieving factors, and the S) for severity. In this case study, it is discussed that the child’s breath smells like a puppy dog. While this is describing one symptom there are other symptoms that are being left out. How does the headache feel like? Is the headache stabbing, throbbing, or dull pain? Determining what the headache feels like is important. When reading this case study, it is not discussed what treatment the mother has been
using for the child. Has she been giving him Tylenol or Motrin for his fever? Chloraseptic spray for his throat pain? Zofran or Phenergan for his nausea? Finding out what treatment the mother