Nurs 6630 -- Exam 1: Chapter 49 Upper Respiratory Infection, Pharyngitis, Sinusitis, Otitis Media, and Otitis Externa
1. If a child has not had any
... [Show More] amoxicillin within the last 30 days what medication should the prescriber consider for Acute Otitis Media? - Amoxicillin 80-90 mg/kg/d
2. Dx is based on clinical symptoms and the course of illness. Any persistent URI lasting longer than 10 days without any clinical improvement is likely to be? - Bacterial sinusitis
3. Most common minor acute illness seen in primary care - Upper Respiratory Infections (URI)
4. The most common secondary infections seen with viral URI are: - Sinusitis & otitis media (OM)
5. The most common cause of the common cold - Rhinovirus
6. Other causes of the common cold? -
-Adenovirus
-Respiratory syncytial Virus
-Coronavirus
-Enterovirus
-parainfluenza virus
-influenza virus
7. Using antibiotics for a viral infection leads to? - Antibiotic resistance
8. URI symptoms? -
-nasal congestion
-rhinorrhea
-malaise
-Scratchy throat
-Nasal discharge: starts out thin & clear->then thickens ->green/yellow color
-generalized muscle aches
-Usually no fever in adults
- Low-grade fever in children
9. URI Tx? -
Symptomatic care:
-fluids, antipyretics
-nasal bulb suctioning in infants
-decongestants in older children & adults
10. *NO ABX*
11. URI meds
- Oral Decongestants
--Pseudoephedrine HCL (Sudafed)
12. MOA: promotes drainage & decreases the nasal stuffiness that accompanies a URI. Vasoconstricts capillaries in nasal mucous membranes.
13. Topical Decongestants
--Phenylephrine (Afrin, Neo-Synephrine)
14. -Education: May be used for up to 3 days
15. ***Prolonged use of congestions can cause rebound congestion***
16. Often given to patients for malaise from URI? - Analgesics: acetaminophen (Tylenol), aspirin, & ibuprofen (Motrin)
17. A condition in which the cavities around the nasal passages become inflamed - Sinusitis
18. Must avoid use of decongestants in ? - -Children under 4yrs of age
19. -older adults or patients with cardiovascular disease
20. S/s consistent with sinusitis that lasts 8-12 weeks & confirmed via endoscopy or CT imaging? - Chronic Sinusitis
21. The first choice for antibiotic therapy in acute sinusitis is? - Amoxicillin with or w/ out clavulanate
22. -Dose at 80-90mg/kg/day in high-risk children; 45mg/kg/day in low-risk children
23. -Adults: 500mg 3times a day, or high dose Augmentin
24. The usual length of tx for sinusitis when taking Amoxicillin is? - 5-7 days in adults, 10-14 days in children
25. For penicillin-allergic patients being treated for Sinusitis what is given? - Adults:
26. -Doxycycline 100mg PO bid or 200mg daily
27. -Levofloxacin: 500mg daily
28. -Moxifloxacin: 400mg daily
29. Children: 3rd gen Ceflasporin
30. Cefdinir: 14mg/kg/day
31. Cefuroxime: 30mg/kg/day
32. Cefpodoxime: 10mg/kg/day
33. Drug of choice for chronic sinusitis? - Amoxicillin-clavuantae, respiratory fluoroquinolone, or short course of inhaled or oral corticosteroids
34. What drugs are not recommended for sinusitis? - -Macrolides(azithromycin) and trimethoprim-sulfamethaxazole
35. Sinusitis: Patient education - Saline spray/drops: liquifies secretions & decreases crusting near sinus ostia
36. Topical decongestants: decrease tissue edema & nasal resistance, enhance drainage of secretion from sinus ostia
37. Corticosteroids: Helpful in chronic sinusitis, no evidence in use for acute sinusitis
38. Infection of pharynx or tonsils - Pharyngitis
39. What is the most common cause of pharyngitis? - Most common cause is from respiratory viruses
40. Group A (GAS) most common bacterial cause
41. Group C & Group G beta hemolytic Streptococcus are also a cause
42. Goal of pharyngitis tx - Eradicate bacteria from pharynx
43. prevent development of acute rheumatic fever
44. What medications would the practitioner prescribe for a patient with pharyngitis? - First line tx is Penicillin v or amoxicillin
45. Amoxicillin PO as a single daily dose for 10 days
46. IM penicillin G benzathine
47. If a patient has a non-anaphylactic allergy to penicillin what medication would the practitioner consider prescribing to a patient with pharyngitis? - First generation cephalosporin (cephalexin 20mg/kg/dose BID) for 10 days.
48. Patients with type 1 penicillin allergy who have pharyngitis can be treated with what medication? - Clindamycin or azithromycin
49. URIs resolve in: - 7 -10 days
50. what is the most common reason for prescribing antibiotics in children? - otitis media (OM) [Show Less]