Infection/Immunity Study

Question 1

A 5 month old baby presents to the clinic with acute otitis media. What would the nurse administer to relieve fever and pain?

Answer 1

Tylenol

Question 2

A 3 year old presents to the clinic with ear pain that started this morning. What do you anticipate the doctor recommending?

Answer 2

Watchful waiting

Question 3

A new mom wants to know what can be done to decrease the risk of her. What education would the nurse provide to her?

Answer 3

Breastfeed for at least the first 6 months. Stay up to date with vaccines, especially the pneumococcal vaccine (4 doses that begin at 2 months old) and the influenza vaccine (can be given after 6 months of age). Sit up right when feeding. Do not bottle prop. Eliminate tobacco smoke and any known allergies.

Question 4

A mother of a child with acute otitis media wants to know what are the potential complications of her child’s otitis media becoming chronic?

Answer 4

Speech delays and hearing loss

Question 5

A 2 year old presents to the clinic with tugging at the ear, irritability, and fever for 3 days. After an otoscopic exam, the HCP diagnoses acute otitis media. What first line of treatment do you anticipate the doctor ordering?

Answer 5

Oral amoxicillin twice daily for 5-7 days for treatment of the infection. Rotation of acetaminophen and ibuprofen for fever and pain.

Question 6

When and why should Ibuprofen be administered at night for ear ache rather than acetaminophen?

Answer 6

The effects of ibuprofen lasts longer than that of acetaminophen

Question 7

For nonpharmacological treatment of pain with acute otitis media, what would the nurse recommend?

Answer 7

Lie on the affected side. External application of heat (warm) and cold (cool) compressions

Question 8

What is the second line of antibiotics recommended for acute otitis media when oral amoxicillin is not successful?

Answer 8

Azithromycin and/or Cephalosporin

Question 9

What medication is recommended for highly antibiotic resistant otitis media or noncompliance with previous antibiotic therapy?

Answer 9

IM ceftriaxone

Question 10

What ear drops can a HCP prescribe to help relieve pain from acute otitis media?

Answer 10

Benzocaine drops

Question 11

When is a tympanostomy or myringotomy recommended for a patient with acute otitis media?

Answer 11

After 3 episodes in 6 months or 4 episodes in a year

Question 12

What should a parent be educated about after her child just got tubes placed in the ears (myringotomy/Tympanostomy)?

Answer 12

Tubes will fall out on their own within 8-18 months. Notify the HCP if they fall out before then. Keep ears clean and dry for the first few days. Baths are recommended over showers when bathing to avoid water from entering the ear. Ear wicks should remain loosely placed in ears.

Question 13

How should ear drops be administered to a child?

Answer 13

For children under 3, pull down and back. For children 3 and up, pull up and back.

Question 14

Patient presents to the clinic with issues of the left eye. They report green drainage from the eye, crust around the eye in the mornings, a swollen eyelid, and itchiness. What do you suspect?

Answer 14

Bacterial Conjunctivitis

Question 15

Patient presents to the clinic with watery eyes, inflamed conjuctiva, and swollen eye lids. What do you suspect?

Answer 15

Viral Conjunctivitis

Question 16

Patient presents to the clinic with stringy discharge from both eyes, swollen eyelids and swelling under the eyes. What do you suspect?

Answer 16

Allergic Conjunctivitis

Question 17

What would you expect the HCP to order for a patient with bacterial conjunctivitis?

Answer 17

Topical antibacterial agents

Question 18

What nonpharmocological treatment is used to for bacterial conjunctivitis?

Answer 18

Warm compresses to looses secretions and keep eye clean

Question 19

What nonpharmocological treatment is used for viral conjunctivitis and allergic conjunctivitis?

Answer 19

Cool compresses to help relieve itching

Question 20

Treatment of viral conjunctivitis

Answer 20

Removal of secretions and symptomatic care

Question 21

Treatment of allergic conjunctivitis

Answer 21

Antihistamines

Question 22

What part of the eye should eye drops be administered in?

Answer 22

Conjucntival sac

Question 23

Patient education for someone with bacterial and viral conjunctivitis?

Answer 23

Cloths and wipes used for affected eye(s) should be kept away from others’ belongings. Refrain from rubbing the eye. Use good hand hygiene. Do not reuse items that are used on affected eye(s). Keep eyes clean.

Question 24

What time of the day should eye drops be administered versus eye ointment?

Answer 24

Eye drops should be used during the day while ointment should be used at night because ointment stays in the eye longer but blurs vision

Question 25

Patient was admitted into the hospital with the flu 3 days ago. They have now developed pneumonia. What type of acquired pneumonia is this?

Answer 25

Hospital-acquired pneumonia

Question 26

Patient comes into the ER days after attending a concert. He is eventually diagnosed with pneumonia while in the ER. What type of acquired pneumonia is this?

Answer 26

Community acquired pneumonia

Question 27

Patient presents to the ER, appearing flushed and anxious. with increased respiratory rate, labored breathing, and a productive cough with rust colored sputum. O2 is at 89% on room air. Temperature is 100.5. Crackles are audible in lower lobes. Patient is not up to date on vaccines. What do you suspect the HCP will diagnose this patient with?

Answer 27

Pneumonia

Question 28

A patient comes to the ER from the nursing home with a decreased LOC and O2 is at 88% on room air. A UTI is ruled out. While waiting for the results from the CXRAY, what do you suspect the patient has?

Answer 28

Pneumonia

Question 29

Patient with pneumonia is experiencing SOB and O2 is at 91% on 2L NC. What is the priority nursing intervention?

Answer 29

Increase rate of NC and evaluate the outcome for further interventions

Question 30

Your patient has pneumonia. To improve the patient’s gas exchange and prevent airway obstruction and sepsis, what are your priority interventions?

Answer 30

To improve gas exchange, apply oxygen therapy and encourage bronchia hygiene via an incentive spirometer.
To prevent an airway obstruction, encourage coughing and deep breathing at least every 2 hours, drink at least 2L fluid a day, monitor I&O, monitor mucous membranes and skin turgor, and encourage incentive spirometer at least 10 times an hour while awake
To prevent sepsis, take full course of antibiotics (amoxicillin, ceftriaxone, doxycycline) and steroids. Use bronchodilators and expectorants.

Question 31

What is a common syndrome that can occur from untreated aspiration pneumonia?

Answer 31

ARDS

Question 32

A patient asks about what they can do to help prevent their elderly mother from getting pneumonia. What education would you give them?

Answer 32

Avoid exposure to smoke. Receive pneumonia and flu vaccines. Move around as much as possible.

Question 33

What lab orders do you anticipate the HCP ordering for a patient with suspected pneumonia?

Answer 33

Sputum culture if they have a productive cough, CBC to determine elevated WBC count and to determine if the organism has entered the bloodstream, ABGs to determine baseline arterial oxygen and carbon dioxide levels and to help identify a need for supplemental oxygen, electrolytes,, BUN/Creatinine, influenza testing to rule influenza out since pneumonia often follows pneumonia, and Cxray
because pneumonia usually appears on chest x-ray as an area of increased density