SCIENTIFIC

NURSING EXPLANATION OF
CUES OBJECTIVES INTERVENTIONS RATIONALE EXPECTED OUTCOME
DIAGNOSIS THE PROBLEM
(DIAGNOSIS)
Objective: Acute pain related to Acute otitis media is Short-Term Goals: Independent:  Comprehensive Short-Term Goals:
- Redness around the inflammation of the characterized by Within 8 hours of  Monitor vital signs and assessment helps After 8 hours of nursing
the affected ear middle ear inflammation and nursing interventions observe for signs of identify the nature interventions the patient:
was noted infection of the middle the patient will: distress or discomfort. and severity of the - Reported a
- Facial grimace ear, often secondary to - Report a pain, guiding reduction in pain
with a pain scale microbial invasion and reduction in pain  Position the patient in a appropriate intensity of 3/10.
ranging 4-6 Eustachian tube intensity 2/10. comfortable position, interventions and - Demonstrated
dysfunction. The - Demonstrate such as sitting upright or evaluating their improved ability to
inflammation and buildup improved ability with the affected ear effectiveness. cope with pain as
of fluid in the middle ear to cope with elevated. evidenced by
space can lead to pain as  To minimize reduced facial
increased pressure and evidenced by  Apply warm compresses pressure and grimace.
irritation of the ear reduced or heating pads to the promote drainage. Long-Term Goal:
structures, resulting in grimacing. affected ear. Within 72 hours the
acute pain (otalgia). Long-Term Goal:  To help alleviate patient will:
Within 72 hours the  Encourage relaxation pain and promote  Demonstrated
patient will: techniques, such as deep relaxation of the ear effective pain
 Demonstrate breathing exercises or muscles. management
effective pain guided imagery. strategies and
management  To help distract from absence of ear
strategies and  Encourage the patient to pain and promote pain.
absence of ear maintain adequate comfort.
pain. hydration by drinking
plenty of fluids, preferably  Adequate hydration
water. helps thin mucous
secretions, promotes
Dependent: drainage from the
 Administer analgesic middle ear, and
medications as facilitates resolution
prescribed. of inflammation,
 which can contribute
to pain relief.

 To alleviate pain and

reduce
inflammation.
 BRAND NAME Prescribed dosage, Mechanism
GENERIC NAME frequency, route of Of Indication Contraindication Adverse Reaction Nursing Responsibilities
CLASSIFICATION administration Action
25–50 mg/kg/ day q8h Inhibits bacterial cell Treatment of Serious hypersensitivity to Frequent: GI  Ask pt for history of allergies
BRAND NAME: PO wall synthesis by susceptible infections amoxicillin, other beta- disturbances (mild (esp. penicillins,
Novamoxin binding to PCN-binding due to streptococci, E. lactams. diarrhea, nausea, cephalosporins), renal
proteins. coli, E. faecalis, P. Cautions: History of allergies vomiting), headache, impairment.
Generic name: mirabilis, H. influenzae, (esp. cephalosporins), oral/ vaginal Teach/educate pt & family to:
amoxicillin N. gonorrhoeae, infectious mononucleosis, candidiasis. Occasional:  Continue antibiotic for full
including ear, nose, and renal impairment, asthma. Generalized rash, length of treatment.
throat; lower urticaria.  Space doses evenly.
CLASSIFICATIONS:
respiratory tract; skin  Take with meals if GI upset
Antibiotic
and skin structure; UTIs; occurs.
acute uncomplicated  Report rash, diarrhea, other
gonorrhea; H. pylori. new symptoms.
 Give without regard to food.
 Instruct pt to chew/crush
chewable tablets thoroughly
before swallowing.
 BRAND NAME Prescribed dosage, Mechanism Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME frequency, route of Of
CLASSIFICATION administration Action
200mg q4h PO Reversibly inhibits COX- Treatment of fever, History of hypersensitivity to Occasional (9%–3%):  Assess onset, type, location,
BRAND NAME: 1 and COX-2 enzymes, inflammatory disease, ibuprofen, aspirin, other Nausea, vomiting, duration of pain, inflammation.
Advil resulting in decreased and rheumatoid NSAIDs. Treatment of dyspepsia, dizziness,  Inspect appearance of affected
formation of disorders, perioperative pain in rash. joints for immobility,
Generic name: prostaglandin osteoarthritis, mild to coronary artery bypass graft Rare (less than 3%): deformities, skin condition.
ibuprofen precursors. moderate pain, primary (CABG) surgery. Aspirin triad Diarrhea or  Assess temperature.
Therapeutic Effect: dysmenorrhea, (bronchial asthma, aspirin constipation, flatulence,
Produces analgesic, intolerance, rhinitis). abdominal cramps or Teach/educate pt & family to:
CLASSIFICATIONS:
anti-inflammatory pain, pruritus, increased  Avoid aspirin, alcohol during
NSAID
effects; decreases fever. B/P. therapy (increases risk of GI
Analgesic
Antipyretic bleeding).
 If GI upset occurs, take with
food, milk, antacids.
 May cause dizziness.
 Report ringing in ears,
persistent stomach pain,
respiratory difficulty, unusual
bruising/ bleeding, swelling of
extremities, chest
pain/palpitations.
 BRAND NAME Prescribed dosage, Mechanism Indication Contraindication Adverse Reaction Nursing Responsibilities
GENERIC NAME frequency, route of Of
CLASSIFICATION administration Action
400 mg/day as a single Binds to bacterial cell Treatment of History of Frequent: Oral  Obtain CBC, renal function
BRAND NAME: dose or in 2 divided membranes, inhibits susceptible infections hypersensitivity/anaphylactic candidiasis (thrush), tests.
Suprax doses, PO cell wall synthesis. due to S. pneumoniae, reaction to cefixime, mild diarrhea, mild  Assess for hypersensitivity to
Therapeutic Effect: S. pyogenes, M. cephalosporins. abdominal cramping, cefixime or other
Generic name: Bactericidal. catarrhalis, H. Cautions: History of penicillin vaginal candidiasis. cephalosporins, penicillins.
cefixime influenzae, E. coli, P. allergy, renal impairment.
mirabilis, including otitis Occasional: Nausea, Teach/educate pt & family to:
media, acute bronchitis, serum sickness–like  Continue medication for full
CLASSIFICATIONS:
acute exacerbations of reaction (arthralgia, length of treatment; do not skip
Antibiotic
chronic bronchitis, fever; usually occurs doses.
pharyngitis, tonsillitis, after second course of  Doses should be evenly spaced.
uncomplicated UTI. therapy and resolves  May cause GI upset (may take
after drug is with food or milk).
discontinued).  Report persistent diarrhea.

Rare: Allergic reaction

(rash, pruritus,
urticaria).