Otic Anti-inflammatories and Anti-infectives

Every question here, with the answer

1. A client prescribed amoxicillin-clavulanate 500 mg has only 250 mg tablets at home and plans to take two. What should the nurse teach?

   1. The client must take the 500 mg tablet, because the strengths are not interchangeable.
   2. Crush the two tablets together.
   3. Take one 250 mg tablet twice as often.
   4. Two 250 mg tablets equal one 500 mg tablet, so this is fine.

   Answer: The client must take the 500 mg tablet, because the strengths are not interchangeable.

   Different forms of Augmentin contain different amounts of amoxicillin but the same amount of clavulanic acid, so two 250 mg tablets are not equivalent to one 500 mg tablet. Changing frequency or crushing does not fix the mismatch.

2. A client using otic drops for otitis externa reports dizziness right after each dose. Which teaching point is most relevant?

   1. Warm the bottle by rolling it between the hands before instilling.
   2. Stop the drops and use cotton swabs instead.
   3. Keep the bottle in the refrigerator.
   4. Heat the drops in hot water above body temperature.

   Answer: Warm the bottle by rolling it between the hands before instilling.

   Cold drops can cause dizziness, so the bottle is rolled between the hands to warm it. Refrigerated drops would be cold, overheating can damage the ear canal, and cotton swabs risk perforation.

3. A nurse is teaching a client how to use ciprofloxacin-hydrocortisone ear drops at home. Which instructions are correct? Select all that apply.

   1. Clean the canal with cotton swabs after each dose.
   2. Keep the ear facing up for about 5 minutes after the drops.
   3. Avoid driving until any dizziness has subsided.
   4. Wash hands before handling the bottle.
   5. Report ear pain or worsening itching.

   Answer: Keep the ear facing up for about 5 minutes after the drops., Avoid driving until any dizziness has subsided., Wash hands before handling the bottle., Report ear pain or worsening itching.

   Clients wash hands, keep the ear up for about 5 minutes, report pain or worsening itching (possible superinfection) and avoid driving while dizzy. Cotton swabs are avoided because of the risk of perforation.

4. A client using an otic anti-inflammatory/antibiotic combination for otitis externa has no improvement after 72 hours. What should happen next?

   1. Continue the same drops for another month.
   2. Double the number of drops.
   3. Stop treatment because the infection will clear on its own.
   4. The provider should reassess the client.

   Answer: The provider should reassess the client.

   A treatment response should occur within 48–72 hours; otherwise the provider should reassess. Extending, doubling or stopping without reassessment is not supported, and prolonged use risks superinfection.

5. A client with a latex allergy is starting otic drops for the first time. Which action is most appropriate?

   1. Skip hand hygiene to avoid skin irritation.
   2. Use the standard dropper since the drops do not contain latex.
   3. Use a latex-free dropper and have another person present for the first dose.
   4. Give the first dose at bedtime while the client is alone.

   Answer: Use a latex-free dropper and have another person present for the first dose.

   Clients with latex allergies should use a latex-free dropper, and the first dose is given with another person present in case of a serious allergic reaction. Being alone, using the standard dropper or skipping hand hygiene are unsafe.

6. A child is being treated with amoxicillin for acute otitis media. Which instructions should the nurse give the parent? Select all that apply.

   1. Give all of the antibiotic as prescribed.
   2. Keep follow-up appointments.
   3. Report episodes of diarrhea to the health care provider.
   4. Diarrhea can still appear up to 2 months after the antibiotic ends.
   5. Share leftover antibiotic with a sibling who has ear pain.

   Answer: Give all of the antibiotic as prescribed., Keep follow-up appointments., Report episodes of diarrhea to the health care provider., Diarrhea can still appear up to 2 months after the antibiotic ends.

   Systemic antibiotics can cause diarrhea, including C. difficile, even up to 2 months after therapy, so diarrhea is reported; the full course is taken and follow-up kept. Antibiotics should never be shared.