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Health, Medicine, Nursing
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Case Study
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English (U.S.)
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Antibiotics for a Child with Bilateral Acute Otitis Media

Case Study Instructions:

Case Study:
A 5-year-old male is brought to the primary care clinic by his mother with a chief complaint of bilateral ear pain with acute onset that began “yesterday.” The mother states that the child has been crying frequently due to the pain. Ibuprofen has provided minimal relief. This morning, the child refused breakfast and appeared to be “getting worse.”
Vital signs at the clinic reveal HR 110 bpm, 28 respiratory rate, and tympanic temperature of 103.2 degrees F. Weight is 40.5 lbs. The mother reports no known allergies. The child has not been on antibiotics for the last year. The child does not have history of OM. The child is otherwise healthy without any other known health problems.
Physical examination reveals: Vital signs HR 110 bpm, 28 respiratory rate, and tympanic temperature of 103.2 degrees F. Weight is 40.5 lbs. Bilateral TMs are bulging with severe erythematous. Pneumatic otoscopy reveals absent mobility. Ear canals are normal. After your questioning and examination, you diagnose this child with bilateral Acute Otitis Media. According to the current guidelines on medications for a 5-year-old with Acute Otitis Media (AOM), address the following:
Questions If No, explain why If you decide to recommend/ prescribe medication provide a brief rationale. Give name of medication along with strength, frequency, dosage, and length of treatment. (provide citations) What Parent/Patient Education is essential? (you may use bullet format) What side effects might be expected? (you may use bullet format)
Should the APRN prescribe an antibiotic?
What would the APRN prescribe if this child was allergic to penicillin?
What determines the choice of an antibiotic ?
Will you recommend or prescribe any other medications?
The child returns in 48 hours with increased pain and fever.
What changes will the APRN make in treatment plan?



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Student’s Name
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Questions

If No, explain why

If you decide to recommend/ prescribe medication provide a brief rationale.

What Parent/Patient Education is essential?)

What side effects might be expected?

Should the APRN prescribe an antibiotic?

Yes

For the past year, the ailing child had not taken any antibiotics. The absence of antibiotics in his body makes it weak to resists any infections that may occur. The patient has been diagnosed with bilateral AOM, a common disease for children. Generally, antibiotics are prescribed to children with AOM. The best antibiotics prescription for children with AOM is Amoxicillin (Le Saux & Robinson, 2016). Amoxicillin remains the best medication for children with AOM and has not received the antibiotic within the last 30 days. In the absence of allergy, high-dose amoxicillin is the initial treatment for AOM in children. The antibiotic has several advantages: cost effective, narrow microbiologic spectrum, safe, great taste, and effective. The child should take the amoxicillin dose thrice a day for five days.

* Middle-ear infections are common problems with children
* Formation of effusion in the middle ear resulting in inflation is common
* Erythematous infections are treated with antibiotics
* Drink more fluids while you use the medication
* Medication should be continued until the prescribed dose is completed, even when symptoms disappear after some days. Stopping the medication before the prescription is completed gives the bacteria a chance to grow and the infection will resume.a

* Skin rashes
* Stomach cramps
* Weakness
* Vomiting
* Watery diarrhea
* Fever






What would the APRN prescribe if this child was allergic to penicillin?

cefpodoxime

The patient needs to be given 8mg/kg of cefpodoxime proxetil twice daily for five days (El-Shabrawi, Tolba, & El-Adly, 2016). Cefpodoxime has proved to be an effective antimicrobial agent in treating children with acute otitis media. The antibiotic can be considered as an excellent alternative in treating bacterial AOM for children allergic to penicillin.

* The patient’s caregiver needs to understand the importance of continued administration of medication for it to be effective
* The patient’s caregiver should inform APRN if the child has had any unusual or allergic reactions to the antibiotic.
* The patient’s information about other types of allergies, dyes, food, animals, to mention a few, should also be availed to the healthcare practitioner.
* The p...
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