Patient with Otitis Externa

 

 

 

 

 

 

ZM is an 8-year-old male who is brought to the clinic by his mother for complaints of acute left ear pain. She has recently picked him up from a week-long stay at camp, and he stated his ear hurt so bad he was crying. When his mother looked at this ear, she noticed the outside canal was very swollen. He could not even touch his ear. His mother states: “He is never sick, and he never cries.”

Past Medical History

• All immunizations current

• No history of surgeries

• No history of allergies

• No history of significant illness

Medications

• Multivitamin, daily

• Occasional allergy medication with children’s loratadine

Physical Examination

• Pulse: 100; respiration rate: 22; temperature: 100.2 °F data scan

• Left ear canal swollen; unable to access with otoscope to observe tympanic membrane

• Swelling noted in lymph nodes below ear

• Ear is red and warm to touch

Diagnosis

• External otitis

Discussion Questions

1. What factors in ZM’s recent history should the clinician consider, and what additional questions should the clinician ask the mother?

2. What treatment options are indicated for ZM?

3. What patient teaching should the clinician provide?

Sample Solution

ZM is an 8-year-old male who was brought to the clinic by his mother with complaints of acute left ear pain after a week-long stay at camp. The examination findings revealed swelling in the left ear canal and lymph nodes below the ear, along with redness and warmth to touch, leading to a diagnosis of external otitis. As such, there are several factors from ZM’s recent history that should be considered by the clinician and additional questions asked of his mother before initiating treatment for this condition.

The first factor to consider is ZM’s immunization status. Given that he was recently at camp for a week, it is important for clinicians to know whether or not he has been vaccinated against any illnesses because if not he could be more vulnerable to contracting illnesses like meningitis. Additionally if the clinicians have access to records from previous visits they can review those as well in order make sure all necessary immunizations are up-to-date (U.S Department of Health & Human Services 2020).

Second, it would be beneficial for clinician inquire about ZM’s living environment/situation during camp in order identify potential sources of infection/irritation which may have caused or exacerbated symptoms present e.g., swimming pools, lakes etc.. This line inquiry can lead further questioning concerning potential contact with other children but also animal exposure while away as well (Okanlomo et al., 2017). Finally given that ZM has a history occasional use allergy medication with loratadine it might worthwhile asking how often these medications were taken since antihistamines sometimes used treat external otitis due their anti-inflammatory properties however long term usage could also complicate healing process depending on severity presentation within individual case scenarios (Okanlomo et al., 2017).

As far treatment options indicated recommended therapy depends on degree inflammation observed alongside presence or absence accompanying structures e.g., middle ear involvement(Okanlomo et al., 2017.) For example cases where tympanic membrane appears normal approach typically consists warm compresses inside affected area combined administration topical antibiotics drops though some physicians opt prescribing oral antibiotics based upon patient specific considerations such severity case accompanying strains (U.S Department Health & Human Services 2020). On occasions where deeper structures impacted especially when perforations present then surgical interventions become warranted despite higher risks associated undertaking them (U.S Department Health & Human Services 2020).

 

Breaking down How Stigmas and Media Influence Disordered Eating in Males

Theoretical

There are different organic, mental, and social factors that add to all conditions or scatters (Fitcher and Krenn, 2003) This writing survey examines natural, mental, and social factors that impact confused eating, explicitly in guys. Furthermore, this survey stresses the impact that social marks of shame and media have on sentiments of body disappointment which, thusly, can be related with indications of dietary problems. Sadly, the present society persistently uncovered, both, types of people to messages that disclose to them their body is the thing that characterizes them (Duggan and McCreary, 2004). Such messages can be passed on through social components like ads, slandered sexual orientation jobs, guardians, and media (Ricciardelli and McCabe, 2004). It has been discovered that introduction to these components may prompt disguise of the media’s pre-imagined thoughts of the “impeccable man”, which can be connected to expanded body disappointment (Thompson and Stick, 2001). For most of guys, muscle-arranged body disappointment prompted a drive for strength (McCreary and Sasse, 2000). Indisputably, wild organic components, sociocultural impacts, and mental strife are related with body disappointment and symptomatic confused eating in guys.

Investigating How Stigmas and Media Influence Disordered Eating in Males

Notwithstanding the expanded pervasiveness of dietary issues among ladies, inquire about has appeared scattered eating practices are on the ascent in guys (Furnham, Badmin, and Sneade, 2002). This writing audit partitions factors that impact issue in guys into three gatherings: organic, mental, and social variables (Ricciardelli and McCabe, 2004). The biopsychosocial display, clarifies wellbeing and sickness from a natural, mental, and social point of view (Suls and Rothman, 2004). Besides, this model sees that it isn’t only one framework associated with the experience and results of a person’s wellbeing or disease, however every one of the three frameworks, intuitively working. (Suls &Rothman, 2004). The impact of social marks of disgrace and media on a person’s apparent dimension of body disappointment shows the effect of social impacts on mental working (Harrison and Cantor, 1997). In like manner, wild organic factors, for example, BMI or pubertal planning, may influence dimensions of body disappointment (Ricciardelli and McCabe, 2004).

Tragically, the present society persistently uncovered the two people to messages that reveal to them their body is the thing that characterizes them (Duggan and McCreary, 2004). Messages, for example, these, can be passed on through guardians, slandered sex jobs, and media. It has been discovered that a few people may start to disguise, or really trust society’s pre-considered ideas of allure, and start taking part in dietary problem symptomatology to endeavor to come to these, to some degree unattainable, objectives (Thompson and Stice, 2001). So how do these organic, mental, and social factors explicitly impact confused eating in guys?

Organic Factors of Disordered Eating in Males

Physiological variables comprise of the person’s hereditary cosmetics, a part that one doesn’t really have command over (Suls and Rothman, 2004). Research has appeared two of the most noteworthy natural components connected to dietary problems among guys are weight record (BMI) and pubertal planning (Ricciardelli and McCabe, 2004). Immature guys who were overweight, with a higher BMI, detailed expanded dimensions of body disappointment and societal weights to diminish fat and increment bulk (Ricciardelli and McCabe, 2004). A person with a higher BMI may encounter prodding among friends which could influence the social part of his life. Social disconnection can prompt sentiments of negative effect (misery and tension), abstaining from excessive food intake, and an improved probability of taking part in dietary problem practices (Ricciardelli and McCabe, 2004).

Contrasted with ladies, guys hit adolescence around two years after the fact (Fichter and Kreen, 2003). Pubertal planning, is a natural hazard factor of dietary problems in guys in light of the fact that discouragement, social disconnection, and body disappointment may increment contingent upon when adolescence is experienced (Ricciardelli and McCabe, 2004). Guys who were late to develop experienced expanded dimensions of body disappointment and were bound to swing to be practice subordinate than the individuals who experienced late development (Ricciardelli and McCabe, 2004). Late development likewise expanded manifestations of sorrow, parental clash, and were seen as less well known among their friends (Ricciardelli and McCabe, 2004). It is appeared both of these organic factors adversely influenced the person’s mental and social parts of their life, improving the probability of cluttered eating.

Social Factors of Disordered Eating in Males

Messages concerning society’s optimal body are being dispersed to teenagers by their folks. Research relating to guardians’ job in self-perception unsettling influences among young ladies is known, yet shouldn’t something be said about the job of guardians in the advancement of the self-perception among young men? McCabe and Ricciardelli (2001) led investigate which displayed moms were seen to have a more prominent impact for frames of mind about self-perception on their children’. Besides, it was seen that through positive remarks, moms were progressively persuasive on their child’s self-perception with respect to tolerating abstaining from excessive food intake as a way to shed pounds (Wertheim, Martin, Prior, Sanson, and Smart, 2002).. Then again, through analysis, fathers were all the more tolerating of activity as a procedure for weight reduction (McCabe and Ricciardelli., 2001)

Studies recommend that media patterns might be connected to the improvement of dietary issues in media shoppers. In the present Western culture male’s physical weaknesses are focused by underlining the requirement for exceptional eating regimens, upgrading enhancements, or work out schedules. Notwithstanding the item being sold, the message that men consistently need to improve themselves is being promoted in magazines, for example, Men’s Health. (Duggan and McCreary, 2004). Usually pictures in the media add to body disappointment in ladies however, Pope et al. (2000) has conveyed another point of view to the table concerning guys. Research proposes that men may have it more awful than ladies as far as self-perfect inconsistency (Duggan and McCreary, 2004). Duggan and McCreary (2014) trust that following quite a while of notices in regards to appearance, ladies have figured out how to disregard or face the media (Duggan and McCreary, 2004). Nonetheless, men are seen to be molded to socially keep away from examining such issues and think that its awkward to express their physical uncertainties (Duggan and McCreary, 2004). This finding is a suggestion that men are more powerless to average impacts than ladies as far as body disappointment and accordingly, they will in general purchase promoted items to improve their physical appearance (Pope et al, 2000).

Marks of shame related with sex jobs are a noteworthy supporter of self-perception unsettling influences in guys. The manliness theory recommends that men are in danger for strength situated body disappointment and confused eating because of sex jobs including predominance, certainty, sexual achievement, and physical and passionate poise (Griffiths et al., 2014). Results from this examination demonstrated that more noteworthy muscle disappointment and strength arranged disarranged eating, yet not muscle to fat ratio disappointment or slimness situated cluttered eating, was related with expanded adjustment to manly standards. A conceivable clarification for this is a few guys feel as though they do not have these manly characteristics or are increasingly saved, subsequently they feel as though a bigger, progressively solid body could adjust for those sentiments prompting body disappointment and scattered eating. (Griffiths et al., 2014) So how social factors and messages from the media sway communicate with mental working of a person?

Mental Factors of Disordered Eating in Males

As found in the past areas, organic and social elements are connected to negative affectivity, self-perception disguise, and body disappointment. Self-perception is the manner by which one sees and assesses their appearance and physical ability (Taylor, 2015). Research has appeared changed relationship of self-perception are distinctive in men than ladies. Guys are bound to connect engaging quality with expanded, fit, muscle definition, driving them to a drive for strength (McCreary and Sasse, 2000). Then again, females with body disappointment commonly partner engaging quality with being dainty. (Duggan and McCreary, 2004).

Media patterns might be connected to disguise which, thus, can prompt the improvement of dietary problems (Harrison and Cantor, 1997). People disguise the perfect self-perception that the media depicts due to slandered sexual orientation jobs. This idea, self-perception disguise, alludes to how much an individual truly trusts society’s meaning of allure and participates in practices, for example, cluttered eating, to endeavor to achieve these fairly unattainable thoughts. In this way, it is the disappointment of the body that hypothetically advances counting calories and negative effect, which can expand the hazard for beginning of eating confused manifestations. (Thompson and Stice, 2001).

Dietary problems in Males

There are different kinds of dietary issues, in any case, the most well-known are anorexia nervosa, fanatically eating less junk food and additionally practicing until one achieves a body weight incredibly under ideal dimension, and bulimia, which includes exchanging cycles of pigging out then vomiting utilizing methods, for example, retching, diuretics, outrageous abstaining from excessive food intake, and medication or liquor misuse (Taylor, 2015). Research has appeared there are considerably higher rates of eating disor

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