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 anxious. 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
This study source was downloaded by 100000823822032 from CourseHero.com on 11-02-2021 11:27:17 GMT -05:00
https://www.coursehero.com/file/83188138/Meningitis-Case-Study-Mosbydocx/
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 anxious. 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
This study source was downloaded by 100000823822032 from CourseHero.com on 11-02-2021 11:27:17 GMT -05:00
https://www.coursehero.com/file/83188138/Meningitis-Case-Study-Mosbydocx/
