A nurse is preparing a child who has suspected bacterial meningitis for a lumbar puncture. Which of the following cerebrospinal fluid findings supports the diagnosis?
Decreased WBCs.
Elevated glucose.
Elevated total protein.
Decreased pressure.
The Correct Answer is C
Choice A rationale:
Decreased white blood cells (WBCs) in cerebrospinal fluid (CSF) would not support the diagnosis of bacterial meningitis. In bacterial meningitis, the presence of bacteria triggers an inflammatory response, leading to an increase in WBCs in the CSF (pleocytosis).
Choice B rationale:
Elevated glucose levels in CSF would actually be more consistent with viral rather than bacterial meningitis. In bacterial meningitis, glucose levels are typically decreased due to the high metabolic demands of bacteria on the glucose present in the CSF.
Choice C rationale:
Elevated total protein in cerebrospinal fluid (CSF) is indicative of inflammation and disruption of the blood-brain barrier. Bacterial meningitis causes an intense inflammatory response, leading to an increase in total protein in the CSF.
Choice D rationale:
Decreased pressure in the CSF would not be a characteristic finding in bacterial meningitis. In fact, bacterial meningitis often leads to an increase in CSF pressure due to the inflammation and accumulation of inflammatory cells and proteins.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Implementing fluid restrictions is not recommended for a child with diabetic ketoacidosis (DKA). DKA is characterized by dehydration and electrolyte imbalances, and fluid replacement is a crucial aspect of its management. Restricting fluids could worsen dehydration and hinder the correction of metabolic imbalances.
Choice B rationale:
(Correct Choice) Monitoring vital signs every 8 hours is an important intervention for a school-age child with DKA. Vital signs, including heart rate, respiratory rate, blood pressure, and temperature, provide valuable information about the child's overall condition, fluid status, and response to treatment. More frequent monitoring might be necessary during the acute phase of DKA.
Choice C rationale:
Initiating continuous cardiac monitoring is not typically indicated for a school-age child with DKA. While DKA can have effects on the cardiovascular system, continuous cardiac monitoring is reserved for more critical situations where immediate changes in heart rhythm need to be detected.
Choice D rationale:
Administering subcutaneous insulin 30 minutes before meals is not appropriate for a child with DKA. In DKA management, insulin is typically administered intravenously to achieve more precise control over blood glucose levels. Subcutaneous insulin might not provide the rapid and consistent action needed to address the acute hyperglycemia and metabolic acidosis in DKA.
Correct Answer is B
Explanation
Choice A rationale:
Urine osmolality 500 mOsm/kg. Urine osmolality is a measure of urine concentration and is not a reliable indicator of infection. It reflects the kidney's ability to concentrate urine and can vary based on hydration status and other factors. An elevated urine osmolality could suggest dehydration, not necessarily infection.
Choice B rationale:
WBC 17,500/mm3. This is the correct choice. An elevated white blood cell count (WBC) is a hallmark sign of infection. The body's immune response to an infection often includes an increase in WBC count, particularly the neutrophil count. This elevation is known as leukocytosis and is a red flag for infection.
Choice C rationale:
BUN 12 mg/dL. Blood Urea Nitrogen (BUN) measures kidney function and hydration status. While an elevated BUN can indicate dehydration, it is not a specific marker for infection. BUN levels can be influenced by various factors, including diet and renal function.
Choice D rationale:
Urine specific gravity 1.014. Urine-specific gravity reflects the concentration of solutes in urine and the kidney's ability to concentrate or dilute urine. While changes in urine specific gravity can indicate dehydration or overhydration, it is not a direct indicator of infection. An infection is better detected through changes in WBC count and other clinical signs.
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