A nurse is caring for a client that has been diagnosed with external otitis. Which of the following clinical symptoms should the nurse be monitoring?

Edema of the ear canal.

Purulent drainage from the ear canal.

Burning in the ear canal.

Pain when moving the auricle.

External ear tender to touch.

Answer and Explanation

Correct Answer : A,B,C,D,E

A. Edema of the ear canal is a common symptom of external otitis, indicating inflammation and infection in the area.
B. Purulent drainage from the ear canal often signifies bacterial infection and is a key symptom to monitor.
C. Burning in the ear canal can occur due to inflammation and is a common complaint in external otitis.
D. Pain when moving the auricle is a classic symptom of external otitis, indicating irritation or inflammation of the external ear.
E. Tenderness of the external ear is a common finding in external otitis and should be monitored as it indicates inflammation and potential infection.

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Correct Answer is B

Explanation

B. Assessing pupillary size and reaction provides critical information on brainstem function and can indicate changes in ICP. Changes in pupil size and reaction can signify worsening cerebral function or brain herniation.
A. The Glasgow Coma Scale is useful for assessing consciousness levels but may not be as sensitive for changes in brainstem function in a patient already in an induced coma.
C. Blood pressure and heart rate are vital signs that can suggest increased ICP, but they are not as direct an indicator of cerebral function as pupil assessment.
D. The gag reflex is important but does not provide as direct information about cerebral function related to ICP as pupillary assessment does.

A. Administer calcium binders B. Administer vitamin D supplements C. Administer fluids up to 3000 ml/day D. Administer Furosemide (Lasix) per orders E. Administer oral phosphates

Correct Answer is ["A","C","D"]

Explanation

A. Calcium binders are used to help decrease the amount of calcium absorbed from the gastrointestinal tract, thus lowering calcium levels in the blood.
B. Vitamin D supplements would actually increase calcium levels by enhancing intestinal absorption, so this option is not appropriate in hypercalcemia.
C. Administering fluids helps to dilute serum calcium levels and promote renal excretion of calcium, making it a priority treatment.
D. Furosemide (Lasix) can help promote diuresis, thereby increasing the excretion of calcium through the urine, which is beneficial in managing hypercalcemia.
E. Oral phosphates may be used in some cases to manage hypercalcemia, but they are not a first-line treatment and their administration should be carefully considered in conjunction with other treatments.

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A nurse is caring for a client that has been diagnosed with external otitis. Which of the following clinical symptoms should the nurse be monitoring?

Nursing Test Bank

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