NUR 2513 Maternal Child Nursing Meningitis Case Study

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Meningitis Case Study J.H. is a 5-week-old infant brought to the emergency department (ED) by his mother, who speaks little English. Her husband is at work. She is young and appears frightened and a... nxious. Through a translator, Mrs. H. reports that J.H. has not been eating, sleeps all of the time, and is “not normal.” 1. What are some of the obstacles you need to consider, recognizing that Mrs. H. does not speak or understand English well? 2. You perform your primary assessment and question Mrs. H. with a translator. Which of these findings are abnormal and need to be reported? Select all that apply and state rationale. a. Anterior fontanel palpable and tense b. Pupils equal and +3 c. Temperature 96.8 ° F (36 ° C) rectally d. Heart rate: 85 beats/min e. Positive Babinski reflex f. High-pitched cry g. Refusal of PO intake per mother 3. Where you would assess the Babinski reflex on an infant? J.H. is admitted to the medical unit with the diagnoses of meningitis and rule out sepsis. The ED physician gives the orders shown in the chart. J.H. Chart Emergency Department Orders - CBC with differential - Blood culture - CMP - UA - Cerebrospinal fluid (CSF) for culture, glucose, protein, cell count (following lumbar puncture) Ceftriaxone (Rocephin) 260mg IV now (loading dose) - Acetaminophen (Tylenol) 50mg suppository per rectum for irritability 4. Prioritize the order of your interventions, with 1 being your first action and 7 being your last action. Administer ceftriaxone (Rocephin) Place IV Straight catheterization for urine specimen Place on contact isolation and droplet precautions Assist with lumbar puncture Administer Tylenol Obtain blood culture, CMP 5. You have a difficult time placing the IV line and the physician writes an order to give the Rocephin IM while you wait for the vascular access team to place the IV. Name the appropriate site for an IM injection for an infant. 6. Before administering the ceftriaxone (Rocephin), you must verify the dose with another RN. The therapeutic range is 100mg/kg loading dose and then 80mg/kg daily. J.H. weighs 3.5 kg. Is the loading dose ordered safe? Is it therapeutic? Show your work. 7. Interpret J.H.'s laboratory findings, and explain the rationale for abnormal results. J.H. Chart Laboratory Test Results Urinalysis pH 7.2 Color Clear Leukocytes Negativ [Show More]

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