ATI NURSING CARE OF CHILDREN
QUESTIONS WITH ACCURATE ANSWERS,
Nursing Care of Children Who Have System Disorders ANSWER :-
Acute Neurological Disorders ANSWER :-
Meningitis ANSWER :- viral (aseptic) meningitis- usually only requires supportive care
bacterial (septic) meningitis- contagious, prognosis depending on how quickly care is initiated
Risk factors for meningitis ANSWER :- viral- any viral infection (-virus, mumps,)
bacterial- infections caused by bacterial agents
(meningococcal, pneumococcal, Hib, E.Coli
skull fx, penetrating head wound (access to CSF)
crowded areas
what two vaccines have decreased the incidence of bacterial meningitis in all ages except for infan ts <2?
ANSWER :- the Hib and pneumococcal conjugate vaccines (PCV)
physical assessment findings: meningitis ANSWER :- general: photophobia, nausea, irritability,
headache.
in newborns: ANSWER :- poor, weak muscle tone, poor feeding, poor suck vomiting/diarrhea
neck is supple, bulging fontanels late sign.
,3 months- 2 yrs. ANSWER :- seizures w/ high-pitched cry, bulging fontanels, fever/irritability
2 years- adolescence ANSWER :- seizures are often initial sign
nuchal rigidity
positive Brudinski's sign (flexion of extremities occurring with flexion of the child's neck (due to severe
neck stiffness)
positive Kernig's sign (resistance to extension of child's leg from flexed position (first put at 90 degrees)
petechiae and joint involvement-meningococcal
chronic draining ear-pneumococcal
CSF indicative of meningitis ANSWER :- Bacterial -CLOUDY color, elevated WBC, DECREASED GLUCOSE
and protein, positive gram
Viral- CLEAR color, usually everything normal or slightly elevated, negative gram
Dx ANSWER :- lumbar puncture- THE DEFINITIVE DX TEST FOR MENINGITIS
nursing actions: have child empty bladder
EMLA cream over biopsy area 45 min-1 hr before procedure
side-lying position with head flexed/knee to chest
monitor site for bleeding, hematoma or infection.
client edu: tell pt to remain in flat position in bed to prevent leakage of CSF- spinal headache. time
requires depends on amount of fluid collected. (3-5 test tubes)
Nursing care for meningitis ANSWER :- petechiae or purpuric rash= immediate emergency
, very 1st action when meningitis is suspected is to ISOLATE CLIENT W DROPLET precautions. (pt has
designated equipment, masks for visitors
respiratory isolation for minimum 24 hr after abx therapy has started
V/S, urine output, fluid status, neuro status
NB/INFANTS: head circumference/bulging fontanels
NPO if patient has decreased LOC
decrease environmental stimuli, no pillow, elevate HOB slightly, side lying, bed in low position, seizure
precautions
Meds for meningitis ANSWER :- Antibiotics IV
corticosteroids- not for viral, assists with managing increased ICP
analgesics-assess temp before administering tylenol/ibuprofen
client edu: encourage pt to maintain appropriate immunizations: Hib and PCV should be obtained at
2,4,6 mo and then 12-15 mo.
complication of meningitis: increased ICP ANSWER :- positioning (elevate HOB)
no straining, coughing
minimize stimuli
Reye syndrome ANSWER :- causes liver dysfunction and cerebral edema
peak incidence common between Jan-March (influenza)
QUESTIONS WITH ACCURATE ANSWERS,
Nursing Care of Children Who Have System Disorders ANSWER :-
Acute Neurological Disorders ANSWER :-
Meningitis ANSWER :- viral (aseptic) meningitis- usually only requires supportive care
bacterial (septic) meningitis- contagious, prognosis depending on how quickly care is initiated
Risk factors for meningitis ANSWER :- viral- any viral infection (-virus, mumps,)
bacterial- infections caused by bacterial agents
(meningococcal, pneumococcal, Hib, E.Coli
skull fx, penetrating head wound (access to CSF)
crowded areas
what two vaccines have decreased the incidence of bacterial meningitis in all ages except for infan ts <2?
ANSWER :- the Hib and pneumococcal conjugate vaccines (PCV)
physical assessment findings: meningitis ANSWER :- general: photophobia, nausea, irritability,
headache.
in newborns: ANSWER :- poor, weak muscle tone, poor feeding, poor suck vomiting/diarrhea
neck is supple, bulging fontanels late sign.
,3 months- 2 yrs. ANSWER :- seizures w/ high-pitched cry, bulging fontanels, fever/irritability
2 years- adolescence ANSWER :- seizures are often initial sign
nuchal rigidity
positive Brudinski's sign (flexion of extremities occurring with flexion of the child's neck (due to severe
neck stiffness)
positive Kernig's sign (resistance to extension of child's leg from flexed position (first put at 90 degrees)
petechiae and joint involvement-meningococcal
chronic draining ear-pneumococcal
CSF indicative of meningitis ANSWER :- Bacterial -CLOUDY color, elevated WBC, DECREASED GLUCOSE
and protein, positive gram
Viral- CLEAR color, usually everything normal or slightly elevated, negative gram
Dx ANSWER :- lumbar puncture- THE DEFINITIVE DX TEST FOR MENINGITIS
nursing actions: have child empty bladder
EMLA cream over biopsy area 45 min-1 hr before procedure
side-lying position with head flexed/knee to chest
monitor site for bleeding, hematoma or infection.
client edu: tell pt to remain in flat position in bed to prevent leakage of CSF- spinal headache. time
requires depends on amount of fluid collected. (3-5 test tubes)
Nursing care for meningitis ANSWER :- petechiae or purpuric rash= immediate emergency
, very 1st action when meningitis is suspected is to ISOLATE CLIENT W DROPLET precautions. (pt has
designated equipment, masks for visitors
respiratory isolation for minimum 24 hr after abx therapy has started
V/S, urine output, fluid status, neuro status
NB/INFANTS: head circumference/bulging fontanels
NPO if patient has decreased LOC
decrease environmental stimuli, no pillow, elevate HOB slightly, side lying, bed in low position, seizure
precautions
Meds for meningitis ANSWER :- Antibiotics IV
corticosteroids- not for viral, assists with managing increased ICP
analgesics-assess temp before administering tylenol/ibuprofen
client edu: encourage pt to maintain appropriate immunizations: Hib and PCV should be obtained at
2,4,6 mo and then 12-15 mo.
complication of meningitis: increased ICP ANSWER :- positioning (elevate HOB)
no straining, coughing
minimize stimuli
Reye syndrome ANSWER :- causes liver dysfunction and cerebral edema
peak incidence common between Jan-March (influenza)
