[NP-Clinical] Help with Hives update

[Marilyn Dean]

Kathleen,
How about asking for an ENT referral. Did they max her Anoxicillin to 1000
mg TID? Why more antibiotic? Cough and nasal congestion with clear lungs?
Sounds pretty normal if it has a viral component. Any ongoing fever,
fatigue? How does she look to you?
Marilyn Dean
  -----Original Message-----
  From: np-clinical-bounces at nurse.net
[mailto:np-clinical-bounces at nurse.net]On Behalf Of Kathleen
  Sent: Friday, January 19, 2007 9:48 PM
  To: np-clinical at nurse.net
  Subject: [NP-Clinical] Help with Hives update


  My 15 yo daughter completed a Z pack last Monday, the 15th, still has
urticaria welts that are itchy but fade rather quickly with Benadryl on
board. Still has cough, some nasal congestion. Lungs clear. Doc prescribed
Zyrtec 10 mg qd for hives and Ceftin 500 mg bid for continuing sinus
infection today (to start tomorrow for ten days, after five days on the Z
pack, and 10 days on Amoxicillin). She has had no blood work (even though I
suggested it) or films or cultures done. No hives tonight with only one dose
of Benadryl today.  Doc did not palpate sinuses, just looked in nose (and
asked about allergies to pets, asthma...brother) and mouth and said she had
a lot of drainage. Is not concerned about mono, no lymph nodes are swollen.
I asked about diarrhea and doc suggested eating yogurt. Wants to see her on
Monday if she develops a "rash or hives that won't go away". According to my
drug information, Ceftin should be used with caution in a PCN allergy and
that a culture should be done before prescribing. Thoughts????
  Kathleen, Psych. NP


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