The school nurse suspects a first grade student has sinusitis. Which symptoms might lead the nurse to this suspicion? (Select all that apply.)
a. Child reports tooth pain.
b. Severe wheezing is auscultated on inspiration.
c. Child reports, "I have had a cold for 2 weeks."
d. Nurse observes periorbital swelling.
e. Halitosis is present.
ANS: A, C, D, E
The proximity of the sinus to the tooth roots often results in tooth pain when the sinus is infected. The maxillary and ethmoid sinuses are most often involved in childhood sinusitis. Therefore the signs and symptoms of sinusitis in children are different from those in adults, depending on the age of the child and which sinus is fully developed. An acute sinusitis is suspected when an upper respiratory infection lasts longer than 10 days, with a daytime cough. Halitosis is often present. Untreated sinusitis can lead to periorbital cellulitis. Severe wheezing is not indicative of sinusitis.
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