. A nurse is reviewing the cerebral spinal fluid analysis for a group of clients who have suspected meningitis. Which of the following analysis findings would be consistent with a diagnosis of bacterial meningitis? (Select three answers that apply).
Clear CSF
Cloudy CSF
Negative gram stain.
Decreased glucose content.
Positive gram stain.
Correct Answer : B,D,E
A. Clear CSF: Clear CSF is typically seen in viral meningitis or normal findings, not bacterial meningitis.
B. Cloudy CSF: Cloudy CSF indicates the presence of infection and is characteristic of bacterial meningitis.
C. Negative gram stain: A negative gram stain indicates the absence of bacterial pathogens, which is not consistent with bacterial meningitis.
D. Decreased glucose content: Bacteria consume glucose, leading to decreased glucose levels in bacterial meningitis.
E. Positive gram stain: A positive gram stain confirms the presence of bacterial organisms in the CSF, supporting a diagnosis of bacterial meningitis.
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Correct Answer is A
Explanation
A. "Give her acetaminophen, not aspirin.": Aspirin is contraindicated in children due to the risk of Reye's syndrome, a rare but serious condition that affects the liver and brain, especially during viral illnesses like the flu or chickenpox. Acetaminophen is a safer alternative for fever management in children.
B. "You'll have to call your physician.": While seeking physician advice is important, the nurse has a duty to provide accurate, immediate, evidence-based guidance to prevent harm.
C. "Give her no more than three baby aspirin every 4 hours.": Recommending aspirin dosing is unsafe due to the risk of Reye's syndrome.
D. "Follow the directions on the aspirin bottle for her age and weight.": Providing this advice without addressing safety concerns is inappropriate and potentially harmful.
Correct Answer is B
Explanation
A. Describing manifestations of the illness: Preschoolers lack the cognitive ability to describe symptoms in detail.
B. Relating fears to magical thinking: Magical thinking is characteristic of preschoolers, and they may associate illness with punishment or fantastical causes.
C. Awareness of body function: This is more typical of school-age children, not preschoolers.
D. Understanding cause of illness: Preschoolers do not have the cognitive development to understand illness causation fully.