ATI NURSING CARE OF CHILDREN STUDY GUIDE-LATEST RELIABLE GUIDE
• Bacterial Meningitis
o Couple questions on the ATI Final
o Nursing Care for
... [Show More] 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
• 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
▪ Monitor I&O.
▪ Give oral fluids
▪ Administer IV fluids with electrolyte replacement
▪ Caution with potassium replacement.
▪ Treat and prevent infections
o Screening for Sickle Cell Anemia
▪ Laboratory Test for Sickle Cell Anemia
• Screening for Sickle Cell Anemia in newborns is mandatory in all 50 U.S. states and territories
• CBC
o to detect anemia
• Sickle-Turbidity
o Screening tool detects the presence of HbS but will differentiate the trait from the disease
o The nurse should perform a finger stick on a toddler as a component of the sickle-turbidity test.
▪ If the test is positive, hemoglobin electrophoresis is required to distinguish between children who have
the genetic trait and children who have the disease.
• Hemoglobin Electrophoresis
• Chapter 21: Hematologic Disorders ATI Note:
o Determining Priority Client
▪ Acute vs Chronic; Urgent vs Nonurgent; Stable vs Unstable
• A client who has an acute problem takes priority over a client who has a chronic problem
• A client who has an urgent need takes priority over a client who has a nonurgent need
• A client who has unstable findings takes priority over a client who has stable findings
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