A provider has told a parent that a 3-year-old child has a minor ...

[Zoey63294]

A provider has told a parent that a 3-year-old child has a minor ear infection and that an antibiotic would be prescribed in a couple of days if the child's symptoms worsened.
 
  The parent asks the nurse why the child cannot get an antibiotic today. Which response by the nurse is correct?
  a. If the eardrum ruptures, we can culture the fluid to determine which antibiotic is best.
  b. Most ear infections are caused by viruses, so antibiotics are not effective.
  c. Most ear infections will resolve on their own without antibiotics.
  d. Your child will develop tolerance to antibiotics if they are prescribed too often.

Question 2

A 50-year-old patient receives botulinum toxin type A (Botox) injections for the first time on her forehead and around her eyes. One week later, she calls the clinic to report that she is experiencing droopy eyelids.
 
  The nurse will tell the patient that this effect:
  a. is normal and will resolve in a few days.
  b. may persist for 3 to 6 months but will resolve.
  c. may progress to cause drooling and dysphagia.
  d. represents an adverse effect that may be permanent.

[bbburns21]

Answer to Question 1

ANS: C
The vast majority of acute otitis media (AOM) episodes resolve without treatment, so unless the child is very ill, observation is the initial choice. Spontaneous rupture of the tympanic membrane can occur, but clinicians do not wait for it to happen to obtain a culture that will guide treatment. About 70 to 90 of AOM episodes are bacterial in origin. Patients do not develop tolerance to antibiotic effects; overuse of antibiotics can lead to resistant organisms.

Answer to Question 2

ANS: B
Botox is a neurotoxin that acts on cholinergic neurons to block the release of acetylcholine. Injection into the wrong site or diffusion from the correct site into surrounding tissues can weaken muscles not intended as targets. This patient's droopy eyelids are an example of the wrong site being affected. Weakening of muscles can last 3 to 6 months but will resolve. It is incorrect to tell the patient that it is a normal effect or that it will resolve in a matter of days. Drooling and dysphagia are likely when injections are around the mouth. It is not a permanent effect.