Case Study 82.pdf - Case Study 82 u2013 Meningitis J.H is...

This preview shows page 1 - 3 out of 5 pages.

Case Study 82 – Meningitis J.H. is a 5-week-old infant brought to the ED by his mother, who speaks little English. Her husband is at work. The mother 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 findings are abnormal and need to be reported? Select all that apply and state rationale.
b. Pupils equal and +3 c. Heart rate: 85 d. Positive Babinski reflex e. Refusal of PO intake per mother i. Abnormal for a child not to refusal PO intake, nit common with meningitis f. Anterior fontanel palpable and tense i. The anterior fontanel should be soft and flat. A tense or bulging fontanel can indicate increased intracranial pressure (ICP). The posterior fontanel might be palpable until 2 months of age. g. Temperature 36 C (96.8 F) rectally i. This is hypothermic and abnormal. 3. Place an X where you would assess the Baninski reflex on an infant. !" #$%&’($)*+, -’./0&$ &- 102 *$3 4$.. 0$ *$ 0$-*$) 50)1 6.$0$70)08
CASE STUDY PROGRESS 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 Chart View Emergency Department Orders CBC with differential Blood culture CMP UA Cerebrospinal fluid (CSF) for culture, glucose, protein, cell count (after lumbar puncture) Ceftriaxone (Rocephin) 260 mg IV now (loading dose) Ampicillin 400 mg IV now and then every 6 hrs Acetaminophen 50 mg per rectum for irritability x 1 dose D5W 0.45% NS to infuse at 15 mL/hr 4. Prioritize the order of your interventions, with 1 being your first action and 7 being your last action.

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture