Question

Meningitis Case Study

Jason Hinojosa is a 5-week-old infant brought to the emergency department by his mother, who speaks little English. Her husband is at work. Mrs. Hinojosa is young, anxious, and appears frightened. Through a translator, Mrs. H. reports that her son has not been eating, sleeps all the time, and “is not normal.”

1. What are some of the obstacles you will need to consider, recognizing that Mrs. H. does not speak or understand English well?

2. You perform your primary assessment and question Mrs. H. with a translator. Which of these finding are abnormal and need to be reported? Select all that apply and state rationale.

a. Anterior fontanel palpable and tense

b. Pupils equal and +3

c. Temperature 96.8°F (36°C) rectally

d. Heart rate: 85 beats/min

      e. Positive Babinski reflex

      f.   High-pitched cry

      g. Refusal of PO intake per mother

Jason is admitted to the medical unit with the diagnoses of meningitis and rule out sepsis. The ED physician gives the orders shown in the chart.

Emergency Department Orders:

CBC with differential

Blood culture

CMP

UA

Cerebrospinal fluid (CSF) for culture, glucose, protein, cell count (following lumbar puncture)

Ceftriaxone (Rocephin) 260mg IV now (loading dose)

Acetaminophen (Tylenol) 50 mg suppository per rectum for irritability

3. Prioritize the order of your interventions, with 1 being your first action and 7 being your last action.

            a. Administer Ceftriaxone (Rocephin)                                                ________

            b. Place IV                                                                                          ________

            c. Straight catheterization for urine specimen                                 ________

            d. Place on contact isolation and droplet precautions                     ________

            e. Assist with lumbar puncture                                                         ________

            f. Administer Tylenol                                                                         ________

            g. Obtain blood culture, CMP                                                            ________

4. You have a difficult time placing the IV line and the physician writes and order to give the Rocephin IM while you wait for the vascular access team to place the IV. Name the appropriate site for an IM for an infant.

5. Interpret Jason laboratory findings, and explain the rationale for abnormal results.

Laboratory Tests Results:

Urinalysis

            pH                  7.2

            Color               Clear

            Leukocytes      Negative

Complete Blood Count

            Hct                  32%

            HgB                 10.5 g/dL

            WBC                22,000/mm³

            Sodium           141 mEq/L

Answer 1

What are some of the obstacles you will need to consider, recognizing that Mrs. H. does not speak or understand English well?

Culture in social insurance is likewise a multi-faceted idea. Culture has been characterized as it is through the perspective of culture that individuals characterize wellbeing and disease and see and react to wellbeing messages. Culture will influence from whom social insurance is looked for, how side effects are portrayed, how treatment alternatives are considered, and whether restorative treatment will be picked and clung to.

Confirmation showing that clinicians incline to misjudge their patients' perusing capacities contends for the utilization of an evaluation device. A few wellbeing proficiency evaluation instruments are accessible. Low scores on these evaluations, be that as it may, don't pinpoint the idea of the wellbeing proficiency issue. The low score could be because of low education, restricted English capability, or absence of nature with Western wellbeing terms and ideas. Proficiency evaluation ought to thusly run as a devoted component with appraisals of culture and dialect.

There are no practically equivalent to clinical devices for evaluating society and dialect. Clinicians that acquire point by point data about patients' social gathering enrollment will have significantly more prominent knowledge into their wellbeing convictions than if they just know a patient is, for instance, a non-Hispanic Asian. Accumulation of dialect data additionally should be particular. It isn't sufficient to know a patient's essential dialect or dialect inclination. Research has demonstrated that English capability is a vastly improved indicator of dialect boundaries' effect on wellbeing and human services than essential dialect. Clinicians require data about the level of oral and composed English capability to advise their choices about utilizing translator benefits and interpreted materials.

Clinicians are being urged to convey all the more unmistakably with their patients. Inability to impart unmistakably can result in superfluous return for treatment or prompt torment or unfriendly events. However, wellbeing proficiency, social, and phonetic ways to deal with clear correspondence are particular, and on occasion conflicting. The wellbeing education development focuses on a few precepts of clear correspondence. These incorporate constraining the quantity of messages conveyed at one time, utilizing rearranged, language free dialect, and utilizing the educate back or instruct to objective technique for having patients clarify what they have been told and rehashing the data until the point that it is clear the patient gets it. The cure is to offer people with dialect hindrances bilingual clinicians or translators. Oftentimes, be that as it may, education and social concerns are overlooked. For instance, mediators will rehash muddled, language filled interchanges except if wellbeing proficiency is tended to alongside dialect hindrances. Moreover, clinicians can't expect that mediators and patients share a similar culture since they talk a similar dialect.

You perform your primary assessment and question Mrs. H. with a translator. Which of these finding are abnormal and need to be reported? Select all that apply and state rationale.

a. Anterior fontanel palpable and tense

c. Temperature 96.8°F (36°C) rectally

d. Heart rate: 85 beats/min

f.   High-pitched cry

g. Refusal of PO intake per mother

Explanation:

It is critical for social insurance experts to know about clinical highlights that can be utilized to help distinguish kids and youngsters giving conceivable bacterial meningitis. Meningitis includes irritation of the meninges and spinal line, so it is normally connected with side effects and signs that outcome from this aggravation. Meningitis can be instigated by a few categories of infective living beings, including microscopic organisms and infections: distinguishing contamination because of bacterial meningitis is especially critical in dainty of the fact that provoke acknowledgment and referral for crisis affirmation are basic with a specific end goal to start anti-microbial treatment.