Exhibits

A nurse in an emergency department is caring for a 3-month-old infant. Which of the following actions should the nurse take?

Administer ceftriaxone.

Initiate serum glucose testing every 1 hr.

Administer pneumococcal conjugate vaccine.

Initiate neutropenic precautions.

Answer and Explanation

The Correct Answer is A

A. Administer ceftriaxone. Correct. The CSF analysis shows elevated pressure, cloudy appearance, increased WBC count, elevated protein, and decreased glucose levels, which are indicative of bacterial meningitis. Ceftriaxone is a broad-spectrum antibiotic that is commonly used to treat bacterial meningitis, especially in infants and young children. Immediate administration of antibiotics is crucial to treat the infection and prevent complications.

Other Options:

B. Initiate serum glucose testing every 1 hr. Incorrect. Although the CSF glucose is low, this finding is associated with bacterial meningitis rather than a primary glucose metabolism issue in this context. Regular glucose monitoring every 1 hour is not warranted for managing meningitis. The priority is to address the underlying infection with antibiotics.

C. Administer pneumococcal conjugate vaccine. Incorrect. Vaccination is a preventive measure, not an immediate treatment for an ongoing infection. This infant likely already needs treatment for a current infection, and vaccination would be inappropriate at this stage.

D. Initiate neutropenic precautions.Incorrect. Neutropenic precautions are used for patients with significantly low neutrophil counts to prevent infection. The CSF results do not suggest neutropenia; instead, they suggest an active bacterial infection. The focus should be on treating the infection, not on precautions for low neutrophil count.

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Correct Answer is C

Explanation

A. "I will expect my child to need annual sweat chloride testing." Incorrect. Sweat chloride testing is primarily used for diagnosing cystic fibrosis, not for routine annual monitoring. Once a diagnosis is confirmed, ongoing management focuses on nutritional support, respiratory care, and monitoring for complications.

B. "I will have my child chew the pancrelipase medication before eating." Incorrect. Pancrelipase should not be chewed. It needs to be swallowed whole or sprinkled on acidic food to ensure proper absorption and to avoid irritation of the mouth and esophagus.

C. "I will ensure that my child consumes a high-calorie diet." Correct. Children with cystic fibrosis often require a high-calorie diet due to malabsorption issues and the increased energy expenditure related to their condition. Ensuring adequate caloric intake helps with growth and overall health.

D. "I will administer dornase alfa every 4 hours for wheezing." Incorrect. Dornase alfa (Pulmozyme) is usually administered once or twice daily to help thin mucus in the lungs. It is not typically used every 4 hours or specifically for wheezing.

A. Follows airborne precautions by wearing an N95 respirator while caring for the child B. Maintains droplet precautions while the child is coughing and sneezing C. Wears gloves when assisting the child to the bathroom D. Applies a face mask after entering the child's room

Correct Answer is B

Explanation

A. Follows airborne precautions by wearing an N95 respirator while caring for the child: Pertussis requires droplet precautions, not airborne precautions. An N95 respirator is not necessary.

B. Maintains droplet precautions while the child is coughing and sneezing: Correct. Droplet precautions are appropriate for pertussis, which is spread through respiratory droplets. These precautions help prevent the transmission of the infection.

C. Wears gloves when assisting the child to the bathroom: While wearing gloves is a standard precaution, it does not specifically address the droplet transmission route of pertussis. Gloves alone are not sufficient for preventing the spread of pertussis.

D. Applies a face mask after entering the child's room: The face mask should be applied before entering the room to ensure the nurse is protected from respiratory droplets immediately upon entry.

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Exhibits A nurse in an emergency department is caring for a 3-month-old infant. Which of the following actions should the nurse take?

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Exhibits

A nurse in an emergency department is caring for a 3-month-old infant. Which of the following actions should the nurse take?