Enterovirusis characterized by mild nonspecific febrile illness lasting 2-5 days (summer and early fall peak) (Dains et al., 2016). Affecting mostly children; more males than females with highest prevalence in those under 12 months of age (Burns et al., 2017). According to Burns et al. (2017), rash may be maculopapular or petechial. Upon exam, nonexudative pharyngitis with lymphadenopathy are usually noted, and no diagnostic test is needed (Dains et al., 2016).
Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013).Pharmacotherapeutics for advanced practice: A practical approach(3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.Burns, 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.Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.A parent brings her two year old son to your office because of a chief complaint of fussiness and tugging at his right ear for the past two days. He has had coughing and a runny nose for about 5 days that has been treated with saline nose sprays and a humidifier. He has a low-grade fever of about 101 degrees F (38.3 degrees C) axillaryfor the past two days. Both parents smoke cigarettes. He attends daycare. His past medical history is significant for ear infections in the past, with his last otitis media episode 5 months ago, treated with amoxicillin. His immunizations are up to date, including 13-valent pneumococcal conjugate vaccine.Exam: VS T 38.4, P 100, RR 28, BP 100/65. He is active, alert to his surroundings and otherwise in no distress. HEENT: Right tympanic membrane is erythematous and bulging, with poor mobility on pneumatic otoscopy. Left TM is clear with good mobility. Throat is non-erythematous. There are small cervical lymph nodes. Lungs are clear to auscultation. The rest of the examination is normal.He is diagnosed with acute right otitis media. He is prescribed amoxicillin and acetaminophen. His parent is told to follow up in 2 to 3 days if he is not better, and warned against the dangers of their child to second-hand cigarette smoke.Wk 6---EAR, EYE, NOSE, THROAT DISOREDER----EAR PAIN -OTITIS MEDIAPhysical exam revealed temp 101.5, wt 16kg (unchanged), right ear pain rated at 7/10; with use of otoscope, the right TM appears bulging, erythematous, and limited mobility of the membrane, decreased light reflex and opaque with the presence of pus; post auricular and cervical lymphadenopathy present. Left TM was translucent and pearly grey in color. Patient is up to date with all vaccines.
Ear infections are commonly associated with other upper respiratory tract symptoms such as cold and are common in the winter than summer months (Dains et al., 2016). Based on the above signs and symptoms, Tina was disgnosed with AOM.
You've reached the end of your free preview.
Want to read all 34 pages?
- Spring '18
- urinary tract infection, Burns, Upper respiratory tract infection, pediatric Primary care , Nurs 6541 Exam