NURS 652-EENT Case Study
CASE A
Question 1
25-year-old Robin Jones presents to your clinic complaining of R ear pain for 5 days. She has a 2-day
history of a low-grade fever and cold symptoms for a week consisting of a runny nose with thick yellow
discharge, a cough that occurs mainly at night, and a sore throat. She denies nausea, vomiting, diarrhea,
skin rash, sinus pain, or headache. Her appetite is OK. Robin has taken 2 OTC Motrin with slight relief of
the pain. She has noticed that she doesn’t hear well on the right side.
PMH -generally healthy, negative for allergies and sinusitis
FH -all living and well
Allergies - PCN
Meds -Motrin 400 mg po TID for the last 2 days
Social -current smoker ½ pk daily for 10 years
No ETOH or drugs
Immunizations – Had usual childhood immunizations. Last DT age 13.
PE 5’4” 140#, T 100.8, P-92, RR-20, BP 130/80
External canals clear. R TM is erythematous and bulging with a distorted cone of light; landmarks difficult
to visualize; no retraction; no drainage and decreased mobility on insufflation. L TM pink with a visualized
cone of light; mobility intact on insufflation. Maxillary and frontal sinuses without tenderness. The nasal
mucosa is hyperemic with yellow drainage. Pharynx with slight erythema, no exudates or lesions.
Negative cervical lymphadenopathy. Heart S1S2 RRR no murmur. Breath sounds clear throughout without
rales, wheezes, or rhonchi.
What is your diagnosis? Acute Otitis Media
Question 2
The correct diagnosis is Acute Otitis Media. Please describe the pathophysiology for your diagnosis in
detail (write it as you are explaining to the patient)
CASE A
Question 1
25-year-old Robin Jones presents to your clinic complaining of R ear pain for 5 days. She has a 2-day
history of a low-grade fever and cold symptoms for a week consisting of a runny nose with thick yellow
discharge, a cough that occurs mainly at night, and a sore throat. She denies nausea, vomiting, diarrhea,
skin rash, sinus pain, or headache. Her appetite is OK. Robin has taken 2 OTC Motrin with slight relief of
the pain. She has noticed that she doesn’t hear well on the right side.
PMH -generally healthy, negative for allergies and sinusitis
FH -all living and well
Allergies - PCN
Meds -Motrin 400 mg po TID for the last 2 days
Social -current smoker ½ pk daily for 10 years
No ETOH or drugs
Immunizations – Had usual childhood immunizations. Last DT age 13.
PE 5’4” 140#, T 100.8, P-92, RR-20, BP 130/80
External canals clear. R TM is erythematous and bulging with a distorted cone of light; landmarks difficult
to visualize; no retraction; no drainage and decreased mobility on insufflation. L TM pink with a visualized
cone of light; mobility intact on insufflation. Maxillary and frontal sinuses without tenderness. The nasal
mucosa is hyperemic with yellow drainage. Pharynx with slight erythema, no exudates or lesions.
Negative cervical lymphadenopathy. Heart S1S2 RRR no murmur. Breath sounds clear throughout without
rales, wheezes, or rhonchi.
What is your diagnosis? Acute Otitis Media
Question 2
The correct diagnosis is Acute Otitis Media. Please describe the pathophysiology for your diagnosis in
detail (write it as you are explaining to the patient)
