Chapter 60 Drug Therapy for Disorders of the Ear
A toddler has been diagnosed with otitis media and prescribed amoxicillin. The nurse is performing a follow-up assessment, during which the mother states, "I'm careful to give him his antibiotics on schedule, and a small dose of aspirin when his pain looks like it's flaring up." What is the nurse's priority response? "I'm glad to hear you're maintaining the schedule for his antibiotics." "Make sure not to exceed the recommended dose of aspirin." "Aspirin isn't recommended for use by children because of safety risks" "How often are you having to give him aspirin."
"Aspirin isn't recommended for use by children because of safety risks" Explanation: Children should not take aspirin due to the risk for Reye syndrome. The nurse should certainly assess further, but this safety guideline is a priority because of the risk for harm. There is no safe recommended dose of aspirin for very young children.
A toddler has been diagnosed with otitis media and prescribed amoxicillin. The nurse is performing a follow-up assessment, during which the mother states, "I'm careful to give him his antibiotics on schedule, and a small dose of aspirin when his pain looks like it's flaring up." What is the nurse's priority response? "Make sure not to exceed the recommended dose of aspirin." "Aspirin isn't recommended for use by children because of safety risks" "I'm glad to hear you're maintaining the schedule for his antibiotics." "How often are you having to give him aspirin."
"Aspirin isn't recommended for use by children because of safety risks" Explanation: Children should not take aspirin due to the risk for Reye syndrome. The nurse should certainly assess further, but this safety guideline is a priority because of the risk for harm. There is no safe recommended dose of aspirin for very young children.
A young child has been brought to the clinic with signs and symptoms that are consistent with otitis externa. What assessment question should the nurse ask to address the etiology of this health problem? "Has your child been spending quite a bit of time around animals lately?" "Are all of your child's immunizations up-to-date?" "How would you describe your child's overall level of hygiene?" "Has your child been swimming a lot lately?"
"Has your child been swimming a lot lately?" Explanation: Otitis externa in children is often attributable to moisture in the ear, often because of swimming. Poor hygiene, interaction with animals, and lack of immunizations are not likely to be relevant factors.
A young child has been brought to the clinic with signs and symptoms that are consistent with otitis externa. What assessment question should the nurse ask to address the etiology of this health problem? "How would you describe your child's overall level of hygiene?" "Are all of your child's immunizations up-to-date?" "Has your child been spending quite a bit of time around animals lately?" "Has your child been swimming a lot lately?"
"Has your child been swimming a lot lately?" Explanation: Otitis externa in children is often attributable to moisture in the ear, often because of swimming. Poor hygiene, interaction with animals, and lack of immunizations are not likely to be relevant factors.
After teaching a client how to administer eye drops, the nurse determines that additional teaching is needed when the client makes which statement? Select all that apply. "I'll check to make sure the solution is clear." "I'll drop the solution into the nasal side of the lower eye sac." "I'll check the label to make sure it reads for 'ophthalmic use.'" "I'll be sure not to touch the tip of the dropper to the eye."
"I'll drop the solution into the nasal side of the lower eye sac." Explanation: When administering eye drops, the client should check the label to make sure the preparation is for ophthalmic use and it is clear. The client should drop the solution into the middle of the lower conjunctival sac, not directly on the eyeball. The tip should not come into contact with the eye to prevent contamination.
After teaching a client how to administer eye drops, the nurse determines that additional teaching is needed when the client makes which statement? Select all that apply. "I'll check to make sure the solution is clear." "I'll drop the solution into the nasal side of the lower eye sac." "I'll be sure not to touch the tip of the dropper to the eye." "I'll check the label to make sure it reads for 'ophthalmic use.'"
"I'll drop the solution into the nasal side of the lower eye sac." Explanation: When administering eye drops, the client should check the label to make sure the preparation is for ophthalmic use and it is clear. The client should drop the solution into the middle of the lower conjunctival sac, not directly on the eyeball. The tip should not come into contact with the eye to prevent contamination.
A child with otitis media has been prescribed amoxicillin 900 mg PO daily, in three divided doses. The child's father states, "I'll plan on giving at doses at 6:00 a.m., 2:00 p.m. and 10:00 p.m." What is the nurse's best response? "It's best to administer one larger dose each, which is easier to remember." "It's preferable to take a dose after each of your child's three meals." "Keep doing this until your child's symptoms are fully healed." "That will certainly ensure steady distribution of the medication."
"It's preferable to take a dose after each of your child's three meals." Explanation: Amoxicillin should be taken within an hour of a meal, so connecting administration to the completion of a meal is the ideal strategy. A divided dose cannot be safely bundled into one large dose. The medication should be taken for the full course, not just until symptoms subside.
A nurse in an extended care facility has instilled medicated ear drops into a resident's left ear as prescribed. What instruction should the nurse provide to a client after instilling ear drops into the client's left ear? "Keep lying on your right side for the next 20 minutes or so." "It's important that you avoid touching your left ear for at least the next hour." "Gently massage your left ear until you can hear normally again." "Let's put your hearing aid back in to keep the medication in the ear canal."
"Keep lying on your right side for the next 20 minutes or so." Explanation: After instillation of ear drops, the client should lie on the side opposite the side of administration for 20 minutes to prevent the instillation from running out of the ear canal. It would be inappropriate to reinsert a hearing aid immediately since the medication could harm the hearing aid. It is unnecessary to massage the ear or, conversely, to avoid touching the ear.
A nurse in an extended care facility has instilled medicated ear drops into a resident's left ear as prescribed. What instruction should the nurse provide to a client after instilling ear drops into the client's left ear? "Gently massage your left ear until you can hear normally again." "Keep lying on your right side for the next 20 minutes or so." "It's important that you avoid touching your left ear for at least the next hour." "Let's put your hearing aid back in to keep the medication in the ear canal."
"Keep lying on your right side for the next 20 minutes or so." Explanation: After instillation of ear drops, the client should lie on the side opposite the side of administration for 20 minutes to prevent the instillation from running out of the ear canal. It would be inappropriate to reinsert a hearing aid immediately since the medication could harm the hearing aid. It is unnecessary to massage the ear or, conversely, to avoid touching the ear.
The nurse is conducting a class for new parents and gives what instruction to help prevent the development of otitis media? "Lie the baby down at least halfway through a feeding to prevent the formula from leaking out of his mouth." "Place the baby on his side if he takes a bottle to bed." "Never let the baby sleep drinking a bottle." "If the baby takes a bottle to bed, only put water in it."
"Never let the baby sleep drinking a bottle." Explanation: A baby should never be allowed to sleep while drinking a bottle because of the short, straight eustachian tube of the infant, which allows fluid to enter the ear when the child is lying down.
The nurse is conducting a class for new parents and gives what instruction to help prevent the development of otitis media? "If the baby takes a bottle to bed, only put water in it." "Never let the baby sleep drinking a bottle." "Place the baby on his side if he takes a bottle to bed." "Lie the baby down at least halfway through a feeding to prevent the formula from leaking out of his mouth."
"Never let the baby sleep drinking a bottle." Explanation: A baby should never be allowed to sleep while drinking a bottle because of the short, straight eustachian tube of the infant, which allows fluid to enter the ear when the child is lying down.
A mother is frustrated that her 2-year-old daughter keeps developing ear infections. "I don't understand. Her older brother seldom has any. Why does she have so many?" The nurse explains there can be several different reasons for this. Which of the following might be one of those reasons? "Her son's immune system is in better condition." "Ear infections are more common in girls than boys." "The eustachian tube is straighter in younger children, allowing easy access to pathogens." "Some children are more susceptible to bacterial infections than others."
"The eustachian tube is straighter in younger children, allowing easy access to pathogens." Explanation: Otitis media is more common in younger children because the eustachian tube is straighter, allowing the pathogens to enter the middle ear more easily.
A mother is frustrated that her 2-year-old daughter keeps developing ear infections. "I don't understand. Her older brother seldom has any. Why does she have so many?" The nurse explains there can be several different reasons for this. Which of the following might be one of those reasons? "The eustachian tube is straighter in younger children, allowing easy access to pathogens." "Ear infections are more common in girls than boys." "Her son's immune system is in better condition." "Some children are more susceptible to bacterial infections than others."
"The eustachian tube is straighter in younger children, allowing easy access to pathogens." Explanation: Otitis media is more common in younger children because the eustachian tube is straighter, allowing the pathogens to enter the middle ear more easily.
A mother is frustrated that her 2-year-old daughter keeps developing ear infections. "I don't understand. Her older brother seldom has any. Why does she have so many?" The nurse explains there can be several different reasons for this. Which of the following might be one of those reasons? "The eustachian tube is straighter in younger children, allowing easy access to pathogens." "Her son's immune system is in better condition." "Some children are more susceptible to bacterial infections than others." "Ear infections are more common in girls than boys."
"The eustachian tube is straighter in younger children, allowing easy access to pathogens." Explanation: Otitis media is more common in younger children because the eustachian tube is straighter, allowing the pathogens to enter the middle ear more easily.
The parent of a young child diagnosed with otitis media is alarmed at the possibility of the child being prescribed amoxicillin, stating, "She's absolutely terrified of needles, so I don't know how we'd get her to take the medication." What is the nurse's most appropriate response? "This drug is given by mouth, so there is no need for needles." "There is a lot we can do to minimize pain when an IV is being inserted." "Did your child have a negative experience with needles that she recalls vividly?" "Your health care provider will likely be able to prescribe a different route." "This drug is given by mouth, so there is no need for needles."
"This drug is given by mouth, so there is no need for needles." Explanation: Amoxicillin is administered orally for otitis media, so this route is certain, not just likely. Because of this, the child's previous experiences with needles are not particularly relevant.
The parent of a young child diagnosed with otitis media is alarmed at the possibility of the child being prescribed amoxicillin, stating, "She's absolutely terrified of needles, so I don't know how we'd get her to take the medication." What is the nurse's most appropriate response? "Did your child have a negative experience with needles that she recalls vividly?" "This drug is given by mouth, so there is no need for needles." "There is a lot we can do to minimize pain when an IV is being inserted." "Your health care provider will likely be able to prescribe a different route."
"This drug is given by mouth, so there is no need for needles." Explanation: Amoxicillin is administered orally for otitis media, so this route is certain, not just likely. Because of this, the child's previous experiences with needles are not particularly relevant.
A nurse is providing education to a client who has been prescribed polymyxin B-neomycin-hydrocortisone suspension. The nurse should indicate that the maximum duration of treatment should not exceed how many days? 7 days 14 days 4 days 10 days
10 days Explanation: Adults should instill four drops of polymyxin B-neomycin-hydrocortisone suspension 3 to 4 times daily for no more than 10 days.
A male client has just begun to use Cortisporin Otic for otitis externa. The nurse knows that the client will continue this therapy for how long? 3 weeks 6 weeks 5 days 10 days
10 days Explanation: Cortisporin Otic is used for 10 days.
A male client has just begun to use Cortisporin Otic for otitis externa. The nurse knows that the client will continue this therapy for how long? 5 days 10 days 3 weeks 6 weeks
10 days Explanation: Cortisporin Otic is used for 10 days.
A male client has just begun to use Cortisporin Otic for otitis externa. The nurse knows that the client will continue this therapy for how long? 5 days 6 weeks 3 weeks 10 days
10 days Explanation: Cortisporin Otic is used for 10 days.
A 6-year-old girl has been prescribed amoxicillin for acute otitis media. The nurse notes that on assessment the girl weighs 30 pounds. The nurse calculates the child will be given how much amoxicillin on a daily basis? (Round to nearest kilogram.) 440 mg 360 mg 520 mg 280 mg
280 mg Explanation: Children older than 3 months and weighing less than 40 kg are given amoxicillin 20 to 30 mg/kg/d in divided doses; 30 pounds is converted to 14 kg (30/2.2 = 13.6 or 14); 14 x 20 = 280 mg and 14 x 30 = 420 mg.
A client is prescribed two ophthalmic drugs that are to be administered at about the same time each day. The nurse instructs the client to separate the drug administration by which amount of time? 5-10 minutes 3-5 minutes 10-15 minutes 1-2 minutes
5-10 minutes Explanation: If more than one topical ophthalmic drug is being used, the nurse would instruct the client to administer the drugs at least 5-10 minutes apart.
Pain and fever are frequent issues with ear infections. What would be a safe treatment for toddlers who have pain and/or fever? Aspirin Acetaminophen Ibuprofen Any of the above
Acetaminophen Explanation: Acetaminophen is equivalent to aspirin in analgesic and antipyretic effects and is safe for children. The use of aspirin in children can result in Reye's syndrome, especially when there is a viral infection.
Pain and fever are frequent issues with ear infections. What would be a safe treatment for toddlers who have pain and/or fever? Acetaminophen Aspirin Ibuprofen Any of the above
Acetaminophen Explanation: Acetaminophen is equivalent to aspirin in analgesic and antipyretic effects and is safe for children. The use of aspirin in children can result in Reye's syndrome, especially when there is a viral infection.
Pain and fever are frequent issues with ear infections. What would be a safe treatment for toddlers who have pain and/or fever? Aspirin Acetaminophen Ibuprofen Any of the above
Acetaminophen Explanation: Acetaminophen is equivalent to aspirin in analgesic and antipyretic effects and is safe for children. The use of aspirin in children can result in Reye's syndrome, especially when there is a viral infection.
A school-aged child was diagnosed with otitis media and prescribed a 10-day course of oral amoxicillin. On the seventh day of treatment, the child's mother has contacted the nurse and stated that the child has been symptom-free for the past three days. What is the nurse's bestaction? Advise completion of the antibiotics as prescribed. Encourage the parent to discontinue the medication and follow up with the health care provider. Contact the health care provider to discuss. Encourage the parent to consult with the health care provider.
Advise completion of the antibiotics as prescribed. Explanation: Clients should be advised to complete their prescribed course of antibiotics even if symptoms resolve. Unless the parent reports adverse effects, there is no obvious need to contact the health care provider.
A school-aged child was diagnosed with otitis media and prescribed a 10-day course of oral amoxicillin. On the seventh day of treatment, the child's mother has contacted the nurse and stated that the child has been symptom-free for the past three days. What is the nurse's bestaction? Encourage the parent to consult with the health care provider. Contact the health care provider to discuss. Advise completion of the antibiotics as prescribed. Encourage the parent to discontinue the medication and follow up with the health care provider.
Advise completion of the antibiotics as prescribed. Explanation: Clients should be advised to complete their prescribed course of antibiotics even if symptoms resolve. Unless the parent reports adverse effects, there is no obvious need to contact the health care provider.
The nurse is reviewing a client's medication list before teaching the client about Cipro, a new drug the health care provider has ordered. The nurse warns the client to avoid what until the client finishes the Cipro? Cough syrup Multivitamins Antacids Acetaminophen
Antacids Explanation: Individuals should not take antacids, zinc, or iron supplements during the course of Cipro treatment.
The nurse is reviewing a client's medication list before teaching the client about Cipro, a new drug the health care provider has ordered. The nurse warns the client to avoid what until the client finishes the Cipro? Multivitamins Acetaminophen Antacids Cough syrup
Antacids Explanation: Individuals should not take antacids, zinc, or iron supplements during the course of Cipro treatment.
A child has been diagnosed with acute otitis media. Before the child begins antibiotic treatment, what assessment should the nurse perform? Assess the child for allergies to salicylates. Assess the child for allergies to penicillins. Assess whether the child has ever had tuberculosis skin test. Assess the child's immunization status.
Assess the child for allergies to penicillins. Explanation: Amoxicillin is the preferred antibacterial agent for the treatment of acute otitis media. Because this medication is a penicillin, it is necessary to assess for allergies to these antibiotics. The child's immunization status, history of TB skin tests, and allergies to salicylates are not central to the child's care.
A child has been diagnosed with acute otitis media. Before the child begins antibiotic treatment, what assessment should the nurse perform? Assess the child for allergies to penicillins. Assess the child for allergies to salicylates. Assess the child's immunization status. Assess whether the child has ever had tuberculosis skin test.
Assess the child for allergies to penicillins. Explanation: Amoxicillin is the preferred antibacterial agent for the treatment of acute otitis media. Because this medication is a penicillin, it is necessary to assess for allergies to these antibiotics. The child's immunization status, history of TB skin tests, and allergies to salicylates are not central to the child's care.
After teaching a group of nursing students about various ophthalmic drugs, the instructor determines that the teaching was successful when the students correctly choose which drug as a carbonic anhydrase inhibitor? Latanoprost Brinzolamide Pilocarpine Travoprost
Brinzolamide Explanation: Brinzolamide is a carbonic anhydrase inhibitor. Pilocarpine is a miotic, direct-acing cholinesterase inhibitor. Latanoprost and travoprost are prostaglandin agonists.
After teaching a group of nursing students about various ophthalmic drugs, the instructor determines that the teaching was successful when the students correctly choose which drug as a carbonic anhydrase inhibitor? Brinzolamide Pilocarpine Travoprost Latanoprost
Brinzolamide Explanation: Brinzolamide is a carbonic anhydrase inhibitor. Pilocarpine is a miotic, direct-acing cholinesterase inhibitor. Latanoprost and travoprost are prostaglandin agonists.
The nurse recognizes that the preferred drug of choice for children with necrotizing otitis externa is which of the following? Ciprofloxacin (Cipro) Ofloxacin (Floxin Otic) Cephalexin (Keflex) Amoxicillin (Amoxil)
Cephalexin (Keflex) Explanation: For necrotizing otitis externa, ciprofloxacin is the drug of choice for adults, while cephalexin (Keflex) is the preferred drug for children.
A nurse received a small bottle of drops that read "for otic use only." What part of the body does the nurse know that these drops are to be used in? Ear Eye Mouth Vagina
Ear Explanation: Otic means "auditory" in Latin and refers to anything pertaining to the ear. This nurse knows that these drops are to be used in the ear only. Ophthalmic refers to the eye. Oral refers to the mouth. Vaginal refers to the vaginal canal and surrounding area.
A nurse received a small bottle of drops that read "for otic use only." What part of the body does the nurse know that these drops are to be used in? Vagina Eye Mouth Ear
Ear Explanation: Otic means "auditory" in Latin and refers to anything pertaining to the ear. This nurse knows that these drops are to be used in the ear only. Ophthalmic refers to the eye. Oral refers to the mouth. Vaginal refers to the vaginal canal and surrounding area.
The nurse is evaluating the effectiveness of antibiotic therapy for a client who has been treated for acute otitis media. What assessments will indicate a resolution of the infection? (Select all that apply.) Normal body temperature Cherry red and dull tympanic membrane Improved hearing No bulging of the tympanic membrane Presence of otalgia and otorrhea
Improved hearing No bulging of the tympanic membrane Normal body temperature Explanation: Indications of a resolution of otitis media include the absence of otalgia and otorrhea; improved hearing; a gray, dull tympanic membrane with a cone of light; no bulging of the tympanic membrane; and normal body temperature.
An adult client has been diagnosed with necrotizing otitis externa and has been prescribed a course of ciprofloxacin 500 mg PO q12h. What education should the nurse provide to the client? Select all that apply. Avoid the use of OTC analgesics during treatment. Minimize sun exposure during treatment. Avoid taking antacids during treatment. Complete the prescribed course of antibiotics, regardles of when symptoms resolve. Report any tendon pain promptly.
Minimize sun exposure during treatment. Avoid taking antacids during treatment. Complete the prescribed course of antibiotics, regardles of when symptoms resolve. Report any tendon pain promptly. Explanation: Clients taking ciprofloxacin should be cautioned about photosensitivity, the possibility of tendon pain and/or rupture, and the need to avoid antacids (which will inhibit absorption). As with all antibiotics, completion of the prescribed course should be emphasized. Analgesics do not affect the efficacy of ciprofloxacin and do not create an unsafe drug interaction.
When teaching a client about Cortisporin Otic, the nurse will mention which of the following as a potential adverse effect? Ototoxicity Drainage Redness Inflammation
Ototoxicity Explanation: Adverse effects of Cortisporin Otic include burning, stinging, and ototoxicity.
An elderly patient with malignant necrotizing otitis externa has been transferred from the assisted living facility. The nurse notes this patient also has type 2 diabetes. The health care provider has ordered a culture and sensitivity of the drainage. The nurse recognizes which of the following will probably be the causative pathogen? Pseudomonas aeruginosa Moraxella catarrhalis Proteus Streptococcus pneumoniae
Pseudomonas aeruginosa Explanation: Malignant necrotizing otitis externa occurs in elderly patients with diabetes or patients who are immunocompromised. The causative agent is P. aeruginosa. S. pneumoniae and M. catarrhalis are common pathogens responsible for otitis media. Proteus is a common pathogen responsible for acute otitis externa.
The health care provider has ordered a culture of the purulent drainage in a patient with otitis externa. The nurse recognizes that the most common bacteria that cause otitis externa is which of the following? Aspergillus Pseudomonas aeruginosa Proteus Staphylococcus aureus
Pseudomonas aeruginosa Explanation: P. aeruginosa is the most common bacteria in otitis externa. Research has isolated it as the most common bacteria in swimming pools.
The nurse is preparing to initiate IV Cipro in a patient with necrotizing otitis externa. The nurse is aware that dosage adjustment will be necessary if the patient has a history of which of the following? Pedal edema Renal impairment Fatty liver syndrome Cholecystitis
Renal impairment Explanation: Dosage adjustment of Cipro is necessary for patients with renal impairment.
The nurse is preparing to initiate IV Cipro in a patient with necrotizing otitis externa. The nurse is aware that dosage adjustment will be necessary if the patient has a history of which of the following? Renal impairment Fatty liver syndrome Pedal edema Cholecystitis
Renal impairment Explanation: Dosage adjustment of Cipro is necessary for patients with renal impairment.
A client receiving ophthalmic drugs reports blurred vision. The client tells the nurse, "I almost fell yesterday." The nurse will prioritize which nursing diagnosis for this client? Acute pain Anxiety Risk for injury Risk for infection
Risk for injury Explanation: The client's report of blurred vision and the report of almost falling support the nursing diagnosis of risk for injury. Risk for infection would be appropriate if the client had an infection or did not correctly instill the eyedrops, contaminating the container and/or solution. Acute pain would be more appropriate if the client reported pain either from the disorder or as an adverse effect. Although the client may be anxious, there is no evidence to support it.
A client receiving ophthalmic drugs reports blurred vision. The client tells the nurse, "I almost fell yesterday." The nurse will prioritize which nursing diagnosis for this client? Anxiety Risk for injury Risk for infection Acute pain
Risk for injury Explanation: The client's report of blurred vision and the report of almost falling support the nursing diagnosis of risk for injury. Risk for infection would be appropriate if the client had an infection or did not correctly instill the eyedrops, contaminating the container and/or solution. Acute pain would be more appropriate if the client reported pain either from the disorder or as an adverse effect. Although the client may be anxious, there is no evidence to support it.
A mother has returned to the clinic with her child who appears to have another ear infection. During the assessment the mother mentions that putting the ear drops in is such a pain and after the child starts to feel better, she sometimes forgets to administer them. The nurse cautions the mother that which of the following can occur when antibiotics are not administered correctly? Hypersensitivity to all antibiotics Vertigo Hyperextended tympanic membrane Superinfection
Superinfection Explanation: A superinfection (overgrowth of bacterial or fungal microorganisms) may occur with prolonged or misuse of antibiotics.
A mother has returned to the clinic with her child who appears to have another ear infection. During the assessment the mother mentions that putting the ear drops in is such a pain and after the child starts to feel better, she sometimes forgets to administer them. The nurse cautions the mother that which of the following can occur when antibiotics are not administered correctly? Superinfection Vertigo Hyperextended tympanic membrane Hypersensitivity to all antibiotics
Superinfection Explanation: A superinfection (overgrowth of bacterial or fungal microorganisms) may occur with prolonged or misuse of antibiotics.
A mother has returned to the clinic with her child who appears to have another ear infection. During the assessment the mother mentions that putting the ear drops in is such a pain and after the child starts to feel better, she sometimes forgets to administer them. The nurse cautions the mother that which of the following can occur when antibiotics are not administered correctly? Superinfection Hyperextended tympanic membrane Hypersensitivity to all antibiotics Vertigo
Superinfection Explanation: A superinfection (overgrowth of bacterial or fungal microorganisms) may occur with prolonged or misuse of antibiotics.
The nurse will notify the health care provider immediately if the client taking amoxicillin for otitis media is also taking what medication? Ibuprofen for fever Aspirin for prevention of blood clots Acetaminophen for pain Tetracycline for acne
Tetracycline for acne Explanation: Tetracycline, if taken with amoxicillin, inhibits the action of amoxicillin.
The nurse should suggest to the parents of a toddler diagnosed with otitis media that their child's ear pain can be treated with what over-the-counter adjuvant medication therapy? Select all that apply. acetaminophen ibuprofen lidocaine aspirin benzocaine
acetaminophen ibuprofen Explanation: Acetaminophen is the first-line analgesic for most cases of otalgia accompanying otitis. Acetaminophen is equivalent to aspirin in analgesic and antipyretic effects, and it possesses weak anti-inflammatory properties. This drug is safe for children. Infections of the ear produce pain and may result in fever. The adjuvant medications most commonly administered for relief of pain and fever include agents such as aspirin, acetaminophen, and ibuprofen. When treating such symptoms in a child, aspirin should be avoided. Neither lidocaine nor benzocaine would be appropriate for the management of ear pain.
A client has a diagnosis of otitis media and has just begun antibiotic treatment. The client reports otalgia and has asked for medication. The nurse should anticipate the administration of: acetaminophen (Tylenol). morphine sulfate. ketorolac. hydromorphone (Dilaudid).
acetaminophen (Tylenol). Explanation: Tylenol is the first-line analgesic for most cases of otalgia accompanying otitis. Opioids and ketorolac are not normally indicated.
A client has a diagnosis of otitis media and has just begun antibiotic treatment. The client reports otalgia and has asked for medication. The nurse should anticipate the administration of: hydromorphone (Dilaudid). acetaminophen (Tylenol). ketorolac. morphine sulfate.
acetaminophen (Tylenol). Explanation: Tylenol is the first-line analgesic for most cases of otalgia accompanying otitis. Opioids and ketorolac are not normally indicated.
A 10-year-old client is diagnosed with acute otitis media. What does the nurse anticipate the health care provider will prescribe? neomycin-polymyxin B ciprofloxacin amoxicillin ibuprofen
amoxicillin Explanation: Amoxicillin is the drug of choice for a client with acute otitis media. Ciprofloxacin is prescribed for necrotizing otitis external. Ibuprofen is over the counter and does not require a prescription; although it can be used for pain associated with acute otitis media, it will not treat the infection. Neomycin-polymyxin B is used for external otitis media.
A 10-year-old client is diagnosed with acute otitis media. What does the nurse anticipate the health care provider will prescribe? ciprofloxacin neomycin-polymyxin B amoxicillin ibuprofen
amoxicillin Explanation: Amoxicillin is the drug of choice for a client with acute otitis media. Ciprofloxacin is prescribed for necrotizing otitis external. Ibuprofen is over the counter and does not require a prescription; although it can be used for pain associated with acute otitis media, it will not treat the infection. Neomycin-polymyxin B is used for external otitis media.
The nurse is evaluating the effectiveness of antibiotic therapy for a client who has been treated for acute otitis media. What assessments will indicate a resolution of the infection? (Select all that apply.) Improved hearing Presence of otalgia and otorrhea Normal body temperature Cherry red and dull tympanic membrane No bulging of the tympanic membrane
improved hearing no bulging of the tympanic membrane normal body temperature Explanation: Indications of a resolution of otitis media include the absence of otalgia and otorrhea; improved hearing; a gray, dull tympanic membrane with a cone of light; no bulging of the tympanic membrane; and normal body temperature.
The nurse identifies which as the correct method to instill ear drops in the adult client? pull the pinna of the ear down and forward pull the pinna of the ear up and back leave the pinna in place and instill the drops pull the pinna down and back
pull the pinna of the ear up and back Explanation: When administering an otic drug, the ear canal should be straightened. To straighten the ear canal in the adult and children age 3 years and older, the cartilaginous portion of the outer ear, referred to as the pinna, is gently pulled up and back.
The nurse has administered a client's first scheduled dose of amoxicillin. What subsequent client report should prompt the nurse to seek the discontinuation of this drug? heartburn frontal lobe headache shortness of breath nausea
shortness of breath Explanation: Shortness of breath is suggestive of a hypersensitivity reaction and would likely warrant discontinuation of the drug. Nausea, reflux, and headache should each be addressed, but none likely necessitates discontinuation of drug therapy.