A child has been diagnosed with otitis media with effusion (OME), ...

[Mimi]

A child has been diagnosed with otitis media with effusion (OME), and the child's parent asks the nurse what this means. The nurse will explain that OME is:
 
  a. a condition with a heightened risk of acute otitis media.
  b. an acute ear infection with fluid in the middle ear.
  c. an infection of the skin and tissues of the outer ear.
  d. fluid in the middle ear without localized or systemic infection.

Question 2

A 2-year-old child is seen in the clinic in July with otalgia; erythematous, bulging tympanic membranes; and rupture of the right TM.
 
  The child also has a temperature of 39.4 C. The child's parent tells the nurse, This is the fifth ear infection this year. What can we do? The nurse will expect the provider to:
  a. administer ceftriaxone (Rocephin) IM and give the influenza vaccine.
  b. begin prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole (Septra).
  c. prescribe amoxicillin/clavulanate (Augmentin) and refer the child to an otolaryngologist.
  d. prescribe high-dose amoxicillin (Amoxil) and administer the influenza vaccine.

[marict]

Answer to Question 1

ANS: B
OME occurs in many children after an episode of AOM. It is characterized by fluid in the middle ear without evidence of local or systemic illness. It does not necessarily pose a heightened risk of AOM. OME is not an acute ear infection or an infection of the outer ear.

Answer to Question 2

ANS: C
Recurrent AOM is defined as AOM that occurs three or more times within 6 months or four or more times in a year. Giving an antibiotic, such as Augmentin, is appropriate for each episode, and referral to an ENT specialist is recommended to help reduce risk. IM Rocephin might be an appropriate treatment for an episode, but a flu vaccine is not recommended in July. Prophylactic antibiotic therapy is not recommended. High-dose amoxicillin might be an appropriate treatment for an episode, but a flu vaccine is not recommended in July.

[Mimi]

TYSM

[bdobbins]

Excellent