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Author Question: A patient has been taking an opioid analgesic for 2 weeks after a minor outpatient procedure. At ... (Read 34 times)

renzo156

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A patient has been taking an opioid analgesic for 2 weeks after a minor outpatient procedure.
 
  At a follow-up clinic visit, the patient tells the primary care NP that he took extra doses for the past 2 days because of increased pain and wants an early refill of the medication. The NP should suspect: a. dependence.
  b. drug addiction.
  c. possible misuse.
  d. increasing pain.

Question 2

A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100 F. The primary care NP visualizes bilateral erythematous, nonbulging, intact tympanic membranes.
 
  The child is taking fluids well and is playing with toys in the examination room. The NP should: a. prescribe azithromycin once daily for 5 days.
  b. prescribe amoxicillin twice daily for 10 days.
  c. prescribe amoxicillin-clavulanate twice daily for 10 days.
  d. initiate antibiotic therapy if the child's condition worsens.



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Cheesycrackers

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Answer to Question 1

C
Unsanctioned dose increases are a sign of possible drug misuse. Dependence refers to an abstinence or withdrawal syndrome. Drug addiction is an obsession with obtaining and using the drug for nonmedical purposes. The patient should not have increased pain at 2 weeks.

Answer to Question 2

D
Signs and symptoms of otitis media that indicate a need for antibiotic treatment include otalgia, fever, otorrhea, or a bulging yellow or red tympanic membrane. This child has a low-grade fever, no history of otitis media, a nonbulging tympanic membrane, and no otorrhea, so watchful waiting is appropriate. When an antibiotic is started, amoxicillin is the drug of choice.





 

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