Luke, a 17-month-old, failed treatment with amoxicillin for otitis media. at the two-week recheck, his tm was still erythematous and you cannot see the landmarks. he has persistent nasal congestion, he is not sleeping at night, and he has a 101°f fever. what is the next best step for luke?

The next step is to start treatment with third generation cephalosporin combined or not with B-lactams according to the evolution of the symptoms.

Explanation:

Hello!

Let's solve this!

What you have to keep in mind is:

It is an obstruction of the eustachian tubes.

We have to take the following measures:

Do not breastfeed or take a bottle lying down, do it in a sitting or semi-sitting position due to tubal obstruction. Nebulizations to decongest (with physiological solution)

betamethasone 1 drop / kg 3 times a day, orally for 3 days then twice a day for three days and lie once a day two days

children's paracetamol 5cm every 8 (according to temperature)

It is a congestive catarrhal otitis media compatible with tubal obstruction (eustachian tube

at the nasal level)

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it takes one machine 25 minutes to pick a bale of cotton and another machine 30 minutes to compete the same job. if both machines are used, how long will it take them to pick a bale of cotton?

it takes one machine 25 minutes to pick a bale of cotton and another machine 30 minutes to compete the same job. if both machines are used, how long will it take them to pick a bale of cotton?

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it takes one machine 25 minutes to pick a bale of cotton and another machine 30 minutes to compete the same job. if both machines are used, how long will it take them to pick a bale of cotton?

it takes one machine 25 minutes to pick a bale of cotton and another machine 30 minutes to compete the same job. if both machines are used, how long will it take them to pick a bale of cotton?

it takes one machine 25 minutes to pick a bale of cotton and another machine 30 minutes to compete the same job. if both machines are used, how long will it take them to pick a bale of cotton?

it takes one machine 25 minutes to pick a bale of cotton and another machine 30 minutes to compete the same job. if both machines are used, how long will it take them to pick a bale of cotton?

it takes one machine 25 minutes to pick a bale of cotton and another machine 30 minutes to compete the same job. if both machines are used, how long will it take them to pick a bale of cotton?

it takes one machine 25 minutes to pick a bale of cotton and another machine 30 minutes to compete the same job. if both machines are used, how long will it take them to pick a bale of cotton?

it takes one machine 25 minutes to pick a bale of cotton and another machine 30 minutes to compete the same job. if both machines are used, how long will it take them to pick a bale of cotton?

it takes one machine 25 minutes to pick a bale of cotton and another machine 30 minutes to compete the same job. if both machines are used, how long will it take them to pick a bale of cotton?

it takes one machine 25 minutes to pick a bale of cotton and another machine 30 minutes to compete the same job. if both machines are used, how long will it take them to pick a bale of cotton?

explanation: