Themiddle-aged man has reported a left earache. From his reporting, theearache started two days ago whereby the onset was gradual but it hasincreased steadily resulting in diminished hearing. According to PastMedical History (PMH), the patient has Type 2 diabetes mellitus,hyperlipidemia, and hypertension. For the Advanced Practice Nurse(APN) to be able to distinguish earache (otalgia) from hypertension,hyperlipidemia, and type 2 diabetes, he/she carries out physicalexamination that reveals a weight of 160 pounds, temperature of 98.8degrees Fahrenheit, respiratory rate of 18, height of 5’8”, heartrate of 88, and a blood pressure of 138/76. The APA conducts furtherphysical examinations that reveal vital signs such as the leftperiauricular area of the face being slightly edematous, eyes havingclear sclera, tenderness in the left pinna with edema, clear withoutedema right pinna, a consistent pulse rate of S1 S2 without a murmur,and wheezing (Reiss, 2015).
Thepatient`s medical history played a key role in the process ofphysical examination. Since the man denied upper respiratoryinfection, chills, and fever but the left side of his face swollen,it was possible for the APN to diagnose sinusitis (sinus infection),which causes the nasal passages and sinuses to become inflamed withthe common signs of this type of infection being facial swelling andear pain (Buttaro, 2013). Based on the patient diagnosis, potentialtreatment options involve the use of pain remedies, antibiotics. Thepain remedies include ibuprofen and acetaminophen that availableover-the-counter. Facial pain and swelling are a likelihood of abacterial infection and antibiotics will help. Besides, it is evidentfrom the physical examination that the man has a possible earinfection. Therefore, use of over-the-counter eardrops and holding acold flannel to the swollen area for about twenty minutes are helpful(Nhs.uk, 2015).
Buttaro,T. (2013). Primarycare.St. Louis, Mo.: Elsevier/Mosby.
Nhs.uk,(2015). Earache- NHS Choices.Retrieved 7 December 2015, fromhttp://www.nhs.uk/Conditions/Earache/Pages/Introduction.aspx
Reiss,G. (2015). [Differentialdiagnosis of otalgia]. – PubMed – NCBI.Ncbi.nlm.nih.gov.Retrieved 7 December 2015, fromhttp://www.ncbi.nlm.nih.gov/pubmed/12799915