6-month-old, Caucasian girl was examined by the primary health care practitioner. Subjective Data • Crying and shaking h

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6-month-old, Caucasian girl was examined by the primary health
care practitioner. Subjective Data • Crying and shaking her head
back and forth while in her mother’s arms • Repeatedly tugging at
her right ear • Mother states, • “She has had a cold for the past
couple of days. Her nose has been all snotty, she’s had a hard time
breathing through her nose, and she’s had a bit of diarrhea, too.”
• “About 3 a.m. this morning she woke up crying. I took her
temperature with an armpit thermometer, and it was 101.8°F. She has
been miserable all day.” • “I think she needs antibiotics.” • When
asked about factors that place this child at high risk for ear
infections, the mother states, • “She drinks formula from a
bottle.” • “I try to keep my husband from smoking in the house, but
it’s hard. He hates to have to go out onto the porch to smoke when
it’s so cold outside.” Objective Data Nursing Assessments • Color
pink • Lungs clear • Rhinorrhea • Red, bulging tympanic membrane on
right • Slight bulging of tympanic membrane on left • Current
weight: 15½ lb (consistent growth since last well-child visit)
Health-Care Provider’s Orders • Acetaminophen 80 mg PO every 6
hr—administer first dose in office • Ampicillin 150 mg PO every 6
hr for 10 days • Warm or cold packs to ears, as needed • Instill
saline nasal drops prior to feedings • Diet change: ORT instead of
formula for 2 days • Return for reassessment after completion of
the antibiotic course or earlier, if child shows no
improvement.