Diagnosis and Management of Eye, Ear, Nose, and Throat Disorders
In clinical settings, eye, ear, nose, and throat (EENT) disorders account for the majority of pediatric visits. With the prevalence of these disorders, you must be familiar with their signs and symptoms as well as evidence-based practices for assessment and treatment. Although many pediatric patients present with common EENT disorders such as ear infections, allergies, and strep throat, some patients present with rare disorders requiring specialist care. In your role, making this distinction between when to treat and when to refer is essential. For this Discussion, examine the following case studies and consider potential diagnoses and management strategies.
Case Study 1:
A mother presents with her 2-year-old child with complaints of ear pain and decreased sleep. Earlier this week, he had a runny nose and congestion with a mild cough that occurred mostly when lying down. His temperature is 100.7°F. You note the following physical findings: shotty anterior cervical adenopathy, mild nasal congestion, clear postnasal drainage, and lungs clear to auscultation. Ear examination reveals the following: right tympanic membrane is red, translucent, in a neutral position, with no pus or fluid noted; left tympanic membrane is full, reddish orange in appearance, and opaque with pus.
To prepare:
• Review “Eye Disorders” and “Ear Disorders” in the Burns et al. text.
• Review and select one of the three case studies. Analyze the patient information, including the parent’s perspective.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating parents on the child’s disorder and reducing any concerns/fears presented in the case study.
Please address the following with bold headings:
An explanation of the differential diagnosis for the patient in the case study you selected.
Explain which is the most likely diagnosis for the patient and why.
Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis.
Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments.
Finally, explain strategies for educating parents on their child’s disorder and reducing any concerns/fears presented in the case study.
Readings
• Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care(5th ed.). Philadelphia, PA: Elsevier.
o Chapter 28, “Eye Disorders” (pp. 622–651)
This chapter reviews the development, physiology, and pathophysiology of the eye. It provides guidelines for eye care including assessment and management strategies for common eye disorders, injured eyes, and deformities of the eyelids.
o Chapter 29, “Ear Disorders” (pp. 652–668)
This chapter reviews the structure and function of the ear and presents guidelines for the assessment and management of ear problems.
• American Academy of Pediatrics Clinical Practice Guideline. (2013). The diagnosis and management of acute otitis media. Pediatrics 131(3), pp. e964 -e999. doi: 10.1542/peds.2012-3488
Clinical Practice Guideline: The diagnosis and management of acute otitis media by Lieberthal, A.S., Carroll, A.E., Chonmaitree, T., Ganiats, T.G., Hoberman, A., Jackson, M.A., Joffe ,M.D., Miller, D.T., Rosenfeld, R.M., Sevilla, X.D., Schwartz, R.H., Thomas,P.A., &Tunkel, D.E. in Pediatrics, 131(3), 964-999. Copyright 2013 by American Academy of Pediatrics. Reprinted by permission of American Academy of Pediatrics via the Copyright Clearance Center.
This article examines the diagnosis and management of uncomplicated acute otitis media in patients from 2 months to 12 years of age. It focuses on defining acute otitis media, pain management, assessment, and selection of appropriate antibacterial treatments.
• Wong, D. M., Blumberg, D. A., & Lowe, L. G. (2006). Guidelines for the use of antibiotics in acute upper respiratory tract infections. American Family Physician, 74(6), 956–966. Retrieved fromhttp://www.aafp.org/afp/
This article provides guidelines for diagnosing and treating acute upper respiratory tract infections in children. It focuses on when to treat infections with antibiotics and when not to treat with antibiotics.
