Question

Jane is a 3-year old female brought into the urgent care clinic by her mother. Child has been complaining of left ear pain for the past 2 days. She has had fevers with the last at 101 F; mother treated fever with ibuprofen. No cough, vomiting or diarrhea. You are working with a family practice Nurse Practitioner who diagnoses the child with left otitis media (ear infection). The NP selects amoxicillin suspension for treatment. The NP asks that you double check her dosing and then go through the patient teaching with parent regarding antibiotic treatment. Child weighs 33 lbs. She takes no other medications.

Answer questions 1-3 based on the above information. Include APA reference for your answer when requested.

1. The provider has selected 90 mg per kg dosing for this child; the suspension selected is 400 mg in 5 ml. What quantity would the child receive if the total 24-hour dose was to be divided in two doses and given by mouth every 12 hours (1 point).

2. List two teaching considerations for parents when discussing amoxicillin treatment for bacterial infections. Do not include possible side effects or education regarding possible side effects for your answer. Include APA reference for your answer (2 points).

               b.

3. Mom returns to the clinic 5 days later reporting that low-grade fevers continue and that the child’s ear pain has not improved. Following assessment, the NP decides that the left ear otitis media has not improved and that the child will need to be started on oral Augmentin (amoxicillin with clavulanic acid) suspension. When the NP leaves, the mom asks you why a different antibiotic needs to be started. Respond to the mother’s question using language she will understand. Include APA reference for your answer (2 points).

Answer 1

ANSWERS:-

(1) The quantity of amoxicillin suspension is;

* weight of the child =33lbs

* one lbs =0.454 kilograms

*33 lbs=33 X 0.454 = 14.98kg ;which can be considered as 15 kg. .

* Recommended dose is 90mg per kg.

* The dose for a child with 15 kg = 90x15=1350mg.

* Dose for every 12 hours ( two divided dose) = 1350/2= 675mg per dose.

* The available strength of suspension is 400mg in 5ml.

* So each ml of suspension contains = 400/5 = 80mg per ml.

* 675 mg in ml=675/80= 8.4ml.

* SO THE CHILD WOULD RECEIVE 8,4ml (675mg) by mouth every 12 hours.

(2) Parent teaching include:-

* Continue amoxicillin for the full course,don't discontinue in between which cause résistance to pencillins.

* Give medication at correct time with proper spacing by fixing time for each dose ,should be given at 12 hrs intervals .

* Give medicine with food to reduce gastrointestinal upset.

.*APA reference: Mosby's (2015)drug consult

(3) Response to mother's question:-

* The antibiotics are selected according to the type severity and causing agent(bacteria).

* Depending on the previous infections and antibiotic therapy some bacteria may not respond to particular antibiotics, and in such cases the practitioner change to more stronger and better antibiotics to kill the bacteria.

* Here after 5 days of taking amoxicillin your child still has fever and pain ,showing the  infection is not controlled,because the bacteria is not destroyed by amoxicillin,that is why prescribed with augmentin ,a combination medicine which is powerfull than amoxicillin alone