Common Infectious Conditions

Study Guide for Common Infectious Conditions treated in Outpatient Primary Care Setting NURS 6306 Pharmacology for Advanced Nursing Practice Learner Objectives: 1. Recognize the signs and symptoms of key infectious diseases 2. Identify goals of therapy for these infectious diseases 3. Develop empiric treatment for treating infectious disease 4. Identify diagnostic testing to help guide the clinician’s differential diagnosis 5. Identify the first line pharmacological agents to treat infection 6. Differentiate the lifespan considerations when prescribing medications 7. Develop patient education plan for pts with infection 8. Discuss the implications for vaccinations and infection. 9. Identify the patient who has viral infection vs bacterial infection 10. Identify the diagnostic testing (laboratory and imaging) tests that should be performed to assist in both diagnosis and management of patient with infection. 11. Identify pain as it applies to different infections and how NP can manage it. 12. Identify any black box (BB) warnings with anti infectives prescribed 13. 13. Practice correct method to write out prescriptions for adult and for pediatric patient. Use your pharmacology textbooks (Woo) and clinical guidelines (Cash) to complete the following table. Use first line drugs. Use drugs for outpatient family clinic setting. There will be occasional IM drugs but they will be the exception. Note there are plenty of other dx per system, but these are most common infectious conditions. This is one way to learn your meds per infectious process. Practice writing out prescriptions in the practice script provided. Use one for adult and one for pediatric patient. Common Infectious Conditions

Use different ages/weights for pediatric prescriptions. S/S typical clinical presentation Causative Organism Diagnostic Testing Otalgia irritability, decreased hearing, anorexia, vomiting, fever Streptococcus pneumonia, Haemophilus influenzae, Moraxella catarrhails Otoscopy, pneumatic otoscopy, tympanometry, acoustic reflectometry, bacterial culture Allergic Rhinnitis Nasal congestion, puritus,rhinorrhea, sneezing, itchy nose/palate/eyes, eye redness, puffiness, watery discharge, fatigue, irritability Environmental allergens (e.g. dander, dust mite, mold, potten, and tobacco smoke) Therapeutic trial of antihistamine or internasal corticosteroid, allergen skinprick testing, in vitro specific IgE determination URI – cold Runny/blocked nose, sneezing, sore throat, cough, headache, malaise, fever, sore throat, rhinitis, pleuritic pain, otalgia, sinusitis, altered consciousness, photophobia, hypotonia, neck Infectious Disease Anti-Infective Prescribed Pediatric Considerations Geriatric Considerations Pregnancy Considerations Patient Education Vaccination Considerations BB Immediate pain control as ear pain is cardinal to children Antibiotic caution if renal and hepatic impairment May use during pregnancy and while breastfeeding Most important aspects of treatment is pain control with Tylenol or ibuprofen Allergen avoidance None None HEENT DX Acute OM Amoxicillin or amoxicillin/clavulanate Epiglottis Infectious MONO Influenza Otitis Externa stiffness, seizures, tachycarida Rapidly progressing sore throat with dysphagia, drooling, difficulty in breathing, markedly decreased oral intake, and difficulty in controlling secretions Laryngoscopy, lateral neck radiograph “thumbprint sign”, endoscopic, CBC may show leukocytosis with left shift, blood and epiglottis cultures to identify agent. Fever, fatigure, malaise, pharyngitis, cervical or gereralized lymphadenophathy, fever Ear pain, itching, fullness, with or without decreased hearing, tenderness over tragus, pinna, or both, ear canal manipulation is painful, auditory canal has variable degrees of diffuse edema, cervical lymphadenopathy may be present Pneumatic otoscopy, tympanometry, ear culture, microsopy of exudate/ debris from ear canal, CT scan of the temporal bone with IV contrast, MRI of the brain and internal auditory canals (with and without gadolinium) Peritonsilar Abcess Tonsillitis Strep Pharyngitis Pharyngitis Pain on swallowing, fever, tonsillar exudate, sudden onset of sore throat, headache, abdominal pain, nausea and vomiting, presencse of cough or runny nose, tonsillar erythema, tonsillary enlargement, enlarged anterior cervical lymph nodes Sore throat, fever, headache, nausea, vomiting, abdominal pain (children), rhinorrhea, nasal congestion, cough in viral and absent in bacterial pharyngitis Thoat culture, rapid streptococcal antigen test, serologic testing for streptococci, WBC count and differential, heterophile antibodies, vaginal and cervical, or penile, and rectal cultures, HIV viral load assay, lateral cervical view x-ray, exposed for soft tissue Sinusitis Blepharitis Chalzion Viral Conjunctivitis Allergic Conjunctivitis Bacterial Conjunctivitis Corneal Abrasion Dacryostenosis Neonatal conjunctivitis Respiratory DX Bronchitis Asthma (mild) Bronchiolitis Croup Pertusis COPD Pnuemonia bacterial Community A. Pnuemonia Cough Tuberculosis Cardiac DX Kawasaki Syndrome Rheumatic Fever GI DX AGE H Pylori infection Peptic Ulcer Dz Pinworms Clostridium Diff Travelers Diarrhea GU DX UTI – uncomplicated Complicated UTI Pylonephritis Prostatitis Post streptococcal glomerulonephritis Urethritis STI’s / Gyn Bacterial vaginosis Chlamydia Genital Herpes Gonorrhea HPV PID Syphillis Trichomoniasis Vaginitis (candiasis) Bartholin Cyst/abcess Cervicitis Dermatology Cellulitis Boils/staph infec Diabetic foot infec Scabies Nits/Lice/Pediculosis Acne Burns Cat scratch fever Diaper dermatitis Hand/foot/mouth Bites – cat Bite – dog Bite – human Herpes Simplex Herpes Zoster Dermatophytosis Impetigo Lyme Dz Rocky Mountain Spotted Fever Tinea Capitus Tinea Alba/Versicolor Tinea Corporis Tinea Pedis Onycomycosis Tinea cruris Paronychia Roseola Insect Bites RMSF Systemic Infections Bacterial Meningitis Mumps Varicella Scarlet Fever Fifth Dz Roseola Rubeola West Nile Virus Zika Virus Infection … Common Infectious Conditions