A case of Stephanie Brown, a 3-year-old female with a history of spastic
Question Answered step-by-step A case of Stephanie Brown, a 3-year-old female with a history of spasticcerebral palsy, was admitted to the hospital for intravenous antibiotic therapy, neurologic monitoring, and support for a diagnosis of acute meningitis. Upon arrival at the hospital, Stephanie Brown was febrile, drowsy, and lethargic. Her mother reported a history of vomiting and sever headache. Physical assessment resulted in nuchal rigidity, and positive responses were elicited for both Kernig’s and Brudzinski’s signs. Stephanie Brown was negative for bleeding, rash, petechiae, and photophobia. Cerebral spinal fluid (CSF) results were consistent with meningitis. Droplet precautions are started immediately because meningitis is a serious disease that can be transmitted by droplets. Intravenous antibiotic of Vancomycin was ordered to treat the infection. An intravenous infusion of D5 0.45 NS with 2 mEq of KCl/100 mL to run at 50 mL/hr was initially started at the Emergency which was changed the next day to a rate of 10 mL/hr over 24 hours. The next day when the nurse on duty was rounding, she noticed that the IV site had some swelling and reflected pain and discomfort. The nurse removed the IV and restarted in another site and resume the IV fluids as ordered with the current rate of 10 mL/hr. 1. CDC guidelines require standard precautions for all types of meningitis, as well as droplet precautions for certain types. What else must be done to effectively implement droplet precautions? (Hint: Refer to Appendix A in your textbook: Standard Precautions and Transmission-Based Isolation Precautions.) 2. The above guidelines are implemented immediately and kept in place until 24 hours after antibiotics have been started. Why?1. Suppose you see that Stephanie Brown’s mother is not wearing a mask. When you ask her about this, she says she doesn’t need to do anything special because she never leaves her daughter’s room. How would you respond?2. Every time you walk into the room with your mask on, Stephanie Brown starts to scream. This behavior occurs even when you have observed her through the window quietly playing with her mother before you come in the room. What is going on, and how might you respond? 3. The charge nurse tells you to take care when entering Stephanie Brown’s room and when working with her. She also says to keep stimulation to a minimum. What does she mean, and how do you specifically need to behave? 4. Is Stephanie Brown on any treatment or medication that may contribute to permanent injury? Health Science Science Nursing PEDS 203 Share QuestionEmailCopy link Comments (0)
