A nurse is caring for a toddler who is scheduled to have a lumbar puncture. Which of the following actions should the nurse take?
Restrain the toddler for 1 hr after the procedure.
Place the toddler in a side-lying, knee-chest position.
Ask another nurse to assist with holding the toddler in a prone position.
Swaddle the toddler in a warm blanket.
The Correct Answer is B
A. Restrain the toddler for 1 hr after the procedure: Restraint is not appropriate post-procedure. The child should be monitored for complications but not physically restrained unless medically necessary.
B. Place the toddler in a side-lying, knee-chest position: This position flexes the spine and opens the spaces between the vertebrae, allowing for easier access to the subarachnoid space for the lumbar puncture.
C. Ask another nurse to assist with holding the toddler in a prone position: The prone position is incorrect for lumbar punctures. The side-lying, knee-chest position is standard.
D. Swaddle the toddler in a warm blanket: Swaddling may comfort the toddler but does not facilitate the lumbar puncture.
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Correct Answer is B
Explanation
A. Apply oxygen by nasal cannula: Applying oxygen can be beneficial but is not the immediate priority during an active seizure. Protecting the airway comes first.
B. Turn the client to a lateral position: This action prevents aspiration by keeping the airway clear if the client vomits or has excessive secretions.
C. Administer an anticonvulsant medication: Medications may be necessary later, but immediate safety and airway protection take precedence.
D. Check the client’s oxygen saturation: Monitoring oxygen saturation is important but should follow positioning to ensure airway protection.
Correct Answer is C
Explanation
A. Integumentary: Meningitis affects the central nervous system (CNS), not the skin, though a rash can sometimes appear with meningococcal meningitis.
B. Digestive: Digestive symptoms like nausea and vomiting may occur, but the primary system affected is the CNS.
C. Central Nervous: Meningitis is an inflammation of the meninges, which are protective coverings of the brain and spinal cord in the CNS.
D. Cardiopulmonary: Cardiopulmonary symptoms are not primary features of meningitis, though severe cases may affect vital systems indirectly.