Immunizations Up to date

Meds: Acetaminophen drops 120 mg orally every 4 to 6 hours as needed for fever or pain

ROS: (+) nasal congestion and rhinorrhea, (-) vomiting, diarrhea, or cough PE:

• Gen: Irritable child but consolable

• VS: BP 100/60 mm Hg, P 120 bpm, RR 18 breaths per minute, T 38.6°C (101.5°F)

Identify your treatment goals for this child.

Given this information, what nonpharmacologic and pharmacologic therapy do you recommend?

Presence of middle ear effusion in the absence of symptoms is not an indicator of treatment failure. Persistent effusion greater than 3 months in duration requires a hear-

ing evaluation in children who are otherwise healthy. Preschool-aged and younger children or those at risk for developmental difficulties may need reexamination earlier because speech and hearing impairment is more difficult to assess in these populations.

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