A nurse is taking care of a child with a possible diagnosis of meningitis. The nurse knows to look for which laboratory results to verify the diagnosis?
Decreased pressure and cloudy cerebrospinal fluid with a high protein level.
Clear cerebrospinal fluid with a high protein and low glucose.
Cloudy cerebrospinal fluid with a low protein and low glucose.
Cloudy cerebrospinal fluid with a high protein and low glucose levels.
The Correct Answer is D
A. Decreased pressure and cloudy cerebrospinal fluid with a high protein level. Meningitis usually causes increased intracranial pressure, not decreased.
B. Clear cerebrospinal fluid with a high protein and low glucose. Clear CSF is typically seen in viral meningitis, but bacterial meningitis more often causes cloudy CSF.
C. Cloudy cerebrospinal fluid with a low protein and low glucose. While glucose is low in bacterial meningitis, protein is typically elevated due to the infection.
D. Cloudy cerebrospinal fluid with a high protein and low glucose levels. This finding is consistent with bacterial meningitis, where the CSF is cloudy, protein is elevated due to inflammation, and glucose is low because bacteria consume glucose.
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Correct Answer is D
Explanation
A. "Get the child tested for Reye's syndrome if the child exhibits fever, vomiting, and lethargy.": While these are symptoms of Reye's syndrome, prevention focuses on avoiding triggers like salicylates during viral illnesses, not merely recognizing symptoms.
B. "Use aspirin instead of acetaminophen for children with viral illness.": Aspirin increases the risk of Reye's syndrome in children with viral illnesses.
C. "Advise parents to have their children immunized against Reye's syndrome.": There is no vaccine for Reye's syndrome; prevention relies on avoiding salicylate use during viral infections.
D. "Avoid giving salicylate-containing medications to a child who has a viral syndrome.": Salicylates, such as aspirin, are the primary risk factor for Reye's syndrome, so avoidance is critical.
Correct Answer is B
Explanation
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.