Chapter 81: Parotitis Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. Which physical examination finding suggests viral rather than bacterial parotitis?

a. Clear discharge from Stensen’s duct b. Enlargement and pain of affected glands c. Gradual reduction in saliva production d. Unilateral edema of parotid glands

ANS: A a. Cool compresses b. Discouraging chewing gum c. Surgical drainage d. Topical corticosteroids

Viral parotitis generally produces clear discharge. Enlargement and pain of affected glands may be nonspecific or is associated with tuberculosis (TB) infection. A gradual reduction in saliva, resulting in xerostomia, is characteristic of human immunodeficiency virus (HIV) infection. Unilateral edema is more often bacterial.

2. A patient diagnosed with acute suppurative parotitis has been taking amoxicillin-clavulanate for 4 days without improvement in symptoms. The provider will order an antibiotic for Methicillin-resistant S. aureus. Which other measure may be helpful?

ANS: C

If improvement does not occur after 3 to 4 days of antibiotics, surgical drainage is appropriate. Warm compresses are recommended for comfort. Chewing gum and other methods to stimulate the production of saliva are recommended. Steroids are questionable and topical steroids will have little effect.

Multiple Response

NURSINGTB.COM a. Allergies b. Anticholinergic medications c. Diabetes mellitus d. Hypervolemia e. Radiotherapy

1. What are factors associated with acute suppurative parotitis? (Select all that apply.)

ANS: B, C, E

Anticholinergic medications decrease salivary flow and increase the risk for parotitis. Chronic diseases, including diabetes mellitus, can increase the risk. Radiotherapy and other procedures may increase the risk. Allergies and hypervolemia do not increase the risk.