Croup and Otitis Media, Essay Example

Croup

Management Plan

Treatment with Rationale: Croup is typically treated to alleviate symptoms and to improve comfort in children (BMJ Best Practice, 2011).

Medications: Nebulized corticosteroids in oral form is most common, along with nebulized epinephrine for milder cases in order to reduce symptoms and achieve greater relief (BMJ Best Practice, 2011).

Tests: Common tests include chest and neck x-rays, blood testing, and pulse oximetry to determine a definitive diagnosis (Boston Children’s Hospital, 2013).

Disposition Plan: For patients diagnosed with Croup, the results of laboratory and other testing will determine if the patient requires hospitalization or home care (NHS, 2013). In addition, the type and severity of the cough will determine if the patient warrants hospitalization (NHS, 2013).

Follow-Up Care: The plan of care often includes the use of a humidifier, increased liquid intake, the administration of ibuprofen or acetaminophen, and keeping children calm to prevent agitation and additional symptoms (Boston Children’s Hospital, 2013).

Diet Plan: The child’s diet should be relatively normal with a primary emphasis on increased fluid intake to reduce symptoms (Boston Children’s Hospital, 2013).

Activity Plan: Children should not resume significant physical activities until coughing and related symptoms have improved; therefore, they should partake in rest as much as possible (Boston Children’s Hospital, 2013).

Patient Education

Description of Diagnosis: Croup is caused by a virus that interferes with normal breathing and swollen airway passages (Boston Children’s Hospital, 2013). This condition is most common in children between three months and five years of age (Boston Children’s Hospital, 2013).

New Medication Dosing: The administration of nebulized epinephrine and nebulized corticosteroids is critical to alleviate symptoms and to improve patient outcomes (BMJ Best Practice, 2011).

Possible Side Effects/Adverse Effects: The use of nebulized corticosteroids leads to minimal side effects in patients (WebMD, 2013). If an adverse event occurs, patients should be transported to the emergency department for further treatment and evaluation (WebMD, 2013).

Feedback Techniques: Common feedback techniques include the use of simple language and compassion to alleviate child and parental fears regarding the condition.

Follow-Up Instructions: It is imperative that patients visit their primary care physicians for follow-up in approximately 10-14 days for further evaluation (WebMD, 2013).

Diet Changes: For a patient with Croup, dietary changes are not critical, other than the increased intake of proper fluids (WebMD, 2013).
OTC Medications and Dosing: The use of OTC ibuprofen or acetaminophen are essential as key fever reducers for these patients (Boston Children’s Hospital, 2013).

Otitis Media

Management Plan

Treatment with Rationale: The American Academy of Pediatrics has recently updated its guidelines regarding the treatment of Otitis Media, depending on whether or not the patient is asymptomatic (Wick, 2013). Therefore, it is important to identify any symptoms as early as possible in order to determine if medication is required, or if observation and rest are sufficient (Wick, 2013).

Medications: Common medications include the use of amoxicillin as the first line of defense, depending on the type and severity of the symptoms, and also only if the patient has not taken the drug at any time within the past 30 days (Wick, 2013).

Tests: Typically, no test is required in the first stage because a physician can normally diagnose the condition without further testing (BMJ Best Practice, 2011). However, if testing is warranted, acoustic reflectometry, bacterial culture, and tympanometry may be required to make a definitive diagnosis (BMJ Best Practice, 2011).

Disposition Plan: In most cases, hospitalization is not required to treat Otitis Media; therefore, patients are sent home to recover with one or more prescribed treatments and instructions, depending on the diagnosis (BMJ Best Practice, 2011).

Follow-Up Care: For many patients, follow up care may not be required if symptoms are not evident or are alleviated using the treatment plan (BMJ Best Practice, 2011). However, in some cases, follow up appointments may be required after a period of time to determine if the condition has improved (BMJ Best Practice, 2011).

Diet Plan: For patients with Otitis Media, it is important to administer increased numbers of fluids to improve recovery; however, no additional special dietary restrictions are not typically required (BMJ Best Practice, 2011).

Activity Plan: Patients should rest and not engage in any strenuous physical activity until symptoms have improved (BMJ Best Practice, 2011).

Patient Education

Description of Diagnosis: Otitis Media is also known as an ear infection, or an inflammation of the middle ear, which often coincides with sore throats, respiratory infections, or colds (Boston Children’s Hospital, 2013). These infections are often recurring in young children and even adults in some cases, depending on other clinical factors that are present (Boston Children’s Hospital, 2013).

New Medication Dosing: If antibiotics are warranted, they are typically administered via mouth or through the use of ear drops (Boston Children’s Hospital, 2013). In addition, pain medication, such as ibuprofen or acetaminophen may be necessary to alleviate ear pain in some patients (Boston Children’s Hospital, 2013).

Possible Side Effects/Adverse Effects: The most common side effects of antibiotic medication include nausea, headache, skin rash, and diarrhea and gas (Drugs.com, 2013). If adverse effects such as muscle weakness or jaundice occur, it is necessary to seek emergency medical treatment as soon as possible (Drugs.com, 2013).

Feedback Techniques: Providing reassurance and support to patients with Otitis Media is essential to promote adherence to treatment and the alleviation of symptoms in a timely manner.

Follow-Up Instructions: Follow-up guidelines may include the completion of all required pharmacotherapies, such as antibiotics, in addition to rest and increased fluid intake (Boston Children’s Hospital, 2013).

Diet Changes: No dietary changes are warranted, except for increased fluid intake (Boston Children’s Hospital, 2013).

OTC Medications and Dosing: Acetaminophen or ibuprofen should be administered for pain as necessary (Boston Children’s Hospital, 2013).

References

BMJ Best Practice (2011). Croup: treatment approach. Retrieved from http://bestpractice.bmj.com/best-practice/monograph/681/treatment/step-by-step.html

BMJ Best Practice (2011). Otitis Media: Diagnostic tests. Retrieved from http://bestpractice.bmj.com/bestpractice/monograph/39/diagnosis/tests.html

Boston Children’s Hospital (2013). Croup. Retrieved from http://www.childrenshospital.org/az/Site2134/mainpageS2134P4.html

Boston Children’s Hospital (2013). Otitis Media. Retrieved from http://www.childrenshospital.org/az/Site1399/mainpageS1399P4.html

Drugs.com (2013). Amoxicillin/clavulanate side effects. Retrieved from http://www.drugs.com/sfx/amoxicillin-clavulanate-side-effects.html

NHS (2013). Diagnosing croup. Retrieved from http://www.nhs.uk/Conditions/Croup/Pages/Diagnosis.aspx

WebMD (2013). Asthma treatment: steroids and other anti-inflammatory drugs. Retrieved from http://www.webmd.com/asthma/guide/asthma-control-with-anti-inflammatory-drugs

Wick, J.Y. (2013). New Acute Otitis Media treatment guidelines released. Pharmacy Times, Retrieved from http://www.pharmacytimes.com/news/New-Acute-Otitis-Media-Treatment-Guidelines-Released