The nurse is administering ear drops to a patient with acute ...

[Pea0909berry]

The nurse is administering ear drops to a patient with acute bacterial otitis externa. Which procedure would assist drug penetration into the ear canal?
 
  a. Administering refrigerated drops
  b. Inserting a sponge wick into the ear canal and then administering the drops
  c. Cleaning out the earwax with a cotton-tipped swab before giving the drops
  d. Inserting earplugs after administering the drops

Question 2

A 12-month-old child attends day care and is seen in a clinic for a second middle ear infection since age 8 months.
 
  The parent calls the nurse to report that after the third day of giving amoxicillin (Amoxil), the child continues to have a temperature of 39.5 C and is unable to sleep well because of pain. What will the nurse do?
  a. Encourage the parent to discuss amoxicillin/clavulanate (Augmentin) with the child's provider.
  b. Recommend that the parent consider removing the child from day care to reduce exposure to infection.
  c. Schedule a clinic appointment for the child to clinic to receive ceftriaxone (Rocephin) IM.
  d. Tell the parent the child will probably need surgery for tympanostomy tubes to reduce infections.

[harveenkau8139]

Answer to Question 1

ANS: B
Insertion of a sponge wick can aid delivery of the ear drops to the epithelium of the ear canal. Medication is absorbed into the wick, which delivers the drug to the epithelium. Ear drops should be warmed before administration to prevent dizziness, which may occur with instillation of cold drops. Cerumen should not be removed. Inserting cotton-tipped swabs may damage the epithelium. The use of earplugs may lead to further problems with bacterial otitis externa.

Answer to Question 2

ANS: A
Resistant AOM is on the rise because of the emergence of resistant pathogens such as Haemophilus influenzae and Moraxella catarrhalis, which are resistant to beta-lactam antibiotics, and Streptococcus pneumoniae, which synthesizes altered penicillin-binding proteins. Resistance is treated with high-dose amoxicillin/clavulanate. The high dose of amoxicillin increases activity against amoxicillin-resistant S. pneumoniae, and the clavulanate component overcomes beta-lactam resistance of H. influenzae and M. catarrhalis. Removing a child from day care can help reduce the number of ear infections in infants and young children. This child has only experienced two episodes, and removing the child from day care may not be easy for this family, so this recommendation is not appropriate at this time. IM Rocephin is not recommended. Surgery for bilateral myringotomy tympanotomy tubes (BMTT) is used to reduce the number of episodes in children with recurrent AOM.

[Pea0909berry]

TYSM

[daiying98]

Gracias!