ATI NURSING CARE OF CHILDREN STUDY GUIDE

• Bacterial Meningitis 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 ▪ **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 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 ............................................................................................CONTINUE.