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NURSING 445ATI_Final_Study_Guide_Nursing_care_of_children latest 2022.


ATI Final Study Guide

• Chapter 12: Bacterial Meningitis (starting on page 59)
o Couple questions on the ATI Final

o Nursing Care for Meningitis (Highlights)
▪ Reportable findings: The presence of petechiae or a purpuric-type
rash requires immediate medical attention

▪ Isolate the client as soon as meningitis is suspected and
maintain droplet precautions per facility protocol.
• Droplet precautions require a private room or a room with
clients who have an infection from the same microorganism,
ensuring
that each client has his or her own designated equipment.

• Providers and visitors should wear a mask.

• Maintain respiratory isolation for a minimum of 24 hr.
after initiation of antibiotic therapy.

▪ Decrease environmental stimuli
• Such as providing a quiet environment
• Minimize exposure to bright light (which includes natural
and electric form of lighting)

▪ For newborns and infants, monitor head circumference and
fontanels for presence of or changes in bulging

o Expected Findings of Meningitis
▪ Headache
▪ Nuchal rigidity
▪ Bulging fontanels
▪ Positive Kernig’s sign
▪ Vomiting
▪ Fever and Chills
▪ Irritability
▪ Photophobia
▪ Petechiae (2 years of age or older)

o Need to be familiar with signs and symptoms associated with
increased intracranial pressure (Table 49.3) Page 1383
▪ **bulging fontanelles
▪ **high pitch cry; change in a baby’s cry
▪ **headache

,NURSING 445ATI_Final_Study_Guide_Nursing_care_of_children latest 2022.


▪ **Eye Changes (e.g. Diplopia)
▪ **Vomiting
▪ **Vital Sign Changes
• Elevated temperature and blood pressure;
• decreased pulse and respiration rates

o CSF analysis indicative of meningitis.
▪ BACTERIAL
• Cloudy color (only bacterial will be cloudy)
• Elevated WBC count
• Elevated protein content
• Decreased glucose content
• Positive Gram stain

▪ VIRAL
• Clear color
• Slightly elevated WBC count
• Normal or slightly elevated protein content
• Normal glucose content
• Negative Gram stain

o Treatment/management of Meningitis
• Corticosteroid (such as dexamethasone) to reduce ICP caused by
Meningitis and help prevent hearing loss
• Osmotic Diuretic (such as Mannitol) to reduce ICP caused by Meningitis
and help prevent hearing loss
• Antibiotics (if it is a bacterial infection type of Meningitis)
• Drug Therapy could last up to 10 days
• Educate the family about the need to complete the entire course
of medication

• Important note:
• CSF analysis obtained by lumbar puncture confirms the diagnosis.

• CSF results indicative of meningitis include increased white blood cell
and protein levels, increased ICP, and a glucose level less than 60% of
blood glucose (because bacteria have fed on the glucose).


• Chapter 17: Post-op nursing care for Tonsillectomy Care (page 91 to 92)
o 3-4 questions on the ATI Final

• Chapter 17: Epiglottitis (Page 96)
o 2 questions on the ATI Final

, NURSING 445ATI_Final_Study_Guide_Nursing_care_of_children latest 2022.


o ***Few questions on the final on how to prevent it and also what we would
do if the airway was blocked**
o

• Chapter 19: Cystic Fibrosis (page 105)
o About 2 question on the ATI Final
o Cystic Fibrosis exacerbation
▪ Oxygen saturation of 85%

o Cystic Fibrosis Diet
▪ Well-balanced
▪ High in protein & Calories
▪ Unrestricted fat
▪ Ensure adequate fluid intake


• Chapter 21: Sickle Cell Anemia Section (page 126 to 128);
o 2-3 questions on the ATI Final
o KNOW ABOUT VASO-OCCLUSIVE (ATI KEEPS ASKING ABOUT IT)
▪ Vaso-occlusive is a manifestation and painful episode of sickle
cell disease

▪ Manifestation of Acute Vaso-Occlusive
• Acute Vaso-Occlusive is related to dehydration and
decreased oxygen
• Swollen joints, hands, and feet
• Hematuria
• Visual disturbances

▪ Manifestation of Chronic Vaso-occlusive
• Enlarged Heart
• Enuresis
• Leg Ulcers
• Retinal detachment


o Nursing Care for Sickle Cell Anemia
▪ Promote rest to decrease oxygen consumption.
• Administer oxygen as prescribed if hypoxia is present.
• **Provide intense hydration therapy while maintaining fluid
and electrolyte balance
o Ex. Children often accept flavored popsicles as a source of
fluid

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