Please fallow instructions and APA format with 4 references of each.
Discussion Question 1
SJ is a sixteen-month-old boy who is brought to the clinic with a one-day history of tugging at his right ear and crying and a two-day history of decreased appetite, decreased playfulness, and difficulty sleeping. His mother has documented a fever, so she has been giving him 5 mL of ibuprofen every twelve hours. He was diagnosed with acute otitis media (AOM) at the age of four months; he has had the same diagnosis three times since. On physical exam, his vital signs are normal with the exception of a temperature of 102°F. His weight is 10 kg. Both tympanic membranes (TMs) are erythematous, with the right one more than the left one. The right TM is bulging with limited mobility, copious cerumen, and purulent fluid behind the TM. The left TM appears normal. The right TM landmarks are difficult to visualize. Answer the following questions:
Of the information provided, what data support the diagnosis of AOM and what would be inconclusive?
How would you distinguish AOM and otitis media with effusion (OME)?
What treatment would you suggest?
What types of cautions or instructions would you provide to his mother?
Discussion Question 2
Administration of ophthalmological medications requires some explanation. What are the important points that you would review with a patient when teaching how to instill ophthalmic drops and when teaching how to instill ointment? What are the differences you would need to consider if the patient was a child or if the patient is a geriatric patient? Search the literature to see whether you are able to locate any guidelines to support this teaching.
How to solve
Of the information provided, what data support the diagnosis of AOM and what would be inconclusive? Nursing Assignment Help
Introduction:
As a medical professor, it is important to understand the diagnosis, treatment, and administration of medications for various medical conditions. In this assignment, there are two discussion questions related to the diagnosis and treatment of acute otitis media (AOM) and the administration of ophthalmological medications. The answers to each question will be discussed separately with supporting references in APA format.
Discussion Question 1:
1. Of the information provided, what data support the diagnosis of AOM and what would be inconclusive?
The information provided indicates that the patient has a history of AOM and presents with symptoms such as fever, crying, tugging at the ear, and decreased appetite and playfulness. The physical exam findings reveal erythematous tympanic membranes (TMs), bulging of the right TM with limited mobility, copious cerumen, and purulent fluid behind the TM. These data support the diagnosis of AOM. Inconclusive data would be the difficulty visualizing the right TM landmarks.
2. How would you distinguish AOM and otitis media with effusion (OME)?
AOM and OME are two different conditions that may present similarly. AOM is the infection of the middle ear with the presence of fluid and inflammation, while OME is the presence of fluid without inflammation or infection. The key differences between AOM and OME are symptoms such as fever, pain, and redness of the TM that are present in AOM but not in OME. A physical exam, along with the presence or absence of symptoms, can help in distinguishing AOM from OME.
3. What treatment would you suggest?
The recommended treatment for AOM is antibiotics. AOM is often caused by bacteria that can be treated with antibiotics such as amoxicillin or azithromycin. In addition, pain management with acetaminophen or ibuprofen is suggested. If the patient does not show improvement with antibiotics, further evaluation may be needed.
4. What types of cautions or instructions would you provide to his mother?
The mother should be instructed to give the antibiotics as per instructions and complete the full course of medication. She should use over-the-counter acetaminophen or ibuprofen for pain relief. The mother should also be advised to avoid giving her child any ear drops without consulting a healthcare provider. It is essential to monitor for fever and other symptoms and follow up with the healthcare provider if there is no improvement or worsening of symptoms.
Discussion Question 2:
1. What are the important points that you would review with a patient when teaching how to instill ophthalmic drops and when teaching how to instill ointment?
When teaching a patient how to instill ophthalmic drops, it is important to ensure that they know the correct technique for administration to prevent contamination and ensure therapeutic efficacy. The patient should be advised to wash their hands before and after administration, tilt their head back, and apply the medication drop in the lower eyelid pocket, avoiding touching the eye with the dropper tip. The patient should also keep their eyes closed for 1-2 minutes to allow the medication to distribute evenly.
When teaching a patient how to instill ointment, they should be advised to apply a small amount of medication to the inner eyelid, starting from the inner corner and moving outward. The patient should be instructed not to touch the tip of the tube to the eye or eyelids.
2. What are the differences you would need to consider if the patient was a child or if the patient is a geriatric patient? Search the literature to see whether you are able to locate any guidelines to support this teaching.
In the case of a child or a geriatric patient, the technique for administration of ophthalmic drops or ointment may be different. It is important to consider the patient’s age-related changes such as decreased dexterity, reduced mobility, and changes in vision.
The literature supports the use of modified techniques for administration of ophthalmic medications in children and geriatric patients. For example, infants and young children may require that the ophthalmic medication be administered while they are lying down with their eyes closed. Geriatric patients may require the use of a mirror or magnifying glass for accurate administration of the medication.
References:
1. American Academy of Pediatrics. (2013). Clinical practice guideline: The diagnosis and management of acute otitis media. Pediatrics, 131(3), e964-e999.
2. American Optometric Association. (2019). Care of the patient with ophthalmic medication. Retrieved from https://www.aoa.org/documents/optometrists/CPG-15.pdf
3. Doughty, M. J. (2009). Administration of eye drops and ointments. British Journal of Nursing, 18(1), 16-21.
4. Kanski, J. J. (2011). Clinical ophthalmology: A systematic approach (7th ed.). Elsevier Health Sciences.
