A lumbar puncture (LP) is being done on an infant with suspected ...

[newyorker26]

A lumbar puncture (LP) is being done on an infant with suspected meningitis. The nurse expects which results for the cerebrospinal fluid that can confirm the diagnosis of meningitis?
 
  a. WBCs; glucose
  b. RBCs; normal WBCs
  c. glucose; normal RBCs
  d. Normal RBCs; normal glucose

Question 2

A 23-month-old child is admitted to the hospital with a diagnosis of meningitis. She is lethargic and very irritable with a temperature of 102 F. What should the nurse's care plan include?
 
  a. Observing the child's voluntary movement
  b. Checking the Babinski reflex every 4 hours
  c. Checking the Brudzinski reflex every 1 hour
  d. Assessing the level of consciousness (LOC) and vital signs every 2 hours

[Pswine]

Answer to Question 1

ANS: A
A lumbar puncture is the definitive diagnostic test. The fluid pressure is measured and samples are obtained for culture, Gram stain, blood cell count, and determination of glucose and protein content. The findings are usually diagnostic. The patient generally has an elevated white blood cell count, often predominantly polymorphonuclear leukocytes. The glucose level is reduced, generally in proportion to the duration and severity of the infection.

Answer to Question 2

ANS: D
Observation of vital signs, neurologic signs, LOC, urinary output, and other pertinent data is carried out at frequent intervals on a child with meningitis. The nurse should avoid actions that cause pain or increase discomfort, such as lifting the child's head, so the Brudzinski reflex should not be checked hourly. Checking the Babinski reflex or child's voluntary movements will not help with assessing the child's status.