Use the following Case Study to answer the questions below: Kira, a 3-year-old female, is admitted to the pediatric intensive care unit (PICU) with a diagnosis of bacterial meningitis. Her parents report a 2-day history of fever, irritability, decreased appetite, and vomiting. This morning, they noticed she was less responsive and had a high-pitched cry. Initial Assessment: Vital Signs: Temp 102.8°F (39.3°C), HR 130 bpm, RR 28 breaths/min, BP 110/60 mmHg, SpO2 96% on room air Lethargic, arouses only to painful stimuli. Left pupil 4mm, sluggishly reactive to light; Right pupil 3mm, briskly reactive to light. Anterior fontanelle tense and bulging, withdraws bilateral upper and lower extremities to pain stimuli, no focal deficits noted. Gag reflex present, positive Kernig’s and Brudzinki’s signs. High pitched inconsolable crying. Skin turgor slightly decreased. Past Medical History: Full-term infant, received all age-appropriate vaccinations. No significant past medical history. No recent travel or exposure to sick contacts reported by parents other than a mild cold 1 week prior 1. Based on Kira’s initial assessment findings, which of the following is the most concerning indicator of increased intracranial pressure (ICP) in a 3-year-old? (Place answer for this question in first blank)           A. Heart rate of 130 bpm           B. Temperature of 102.8°F (39.3°C)           C. Sluggishly reactive and unequal pupils           D. Positive Kernig’s and Brudzinski’s signs 2. The nurse is developing a plan of care for Kira. Which nursing intervention is the highest priority for a patient with suspected increased ICP? (Place answer for this question in second blank)        A. Administering antipyretics to reduce fever        B. Maintaining a quiet and dimly lit environment        C. Elevating the head of the bed to 30 degrees with the head in a neutral position        D. Administering broad-spectrum antibiotics as ordered 3. The nurse is monitoring Kira for signs of worsening neurological status. Which of the following, if observed, would indicate a late and critical sign of increased ICP and impending brain herniation? (Place answer for this question in third blank)      A. Restlessness and irritability               B. Headache and nausea      C. Widening cranial sutures and increased head circumference      D. Hypertension, bradycardia, depressed/irregular respirations

A client experiencing homelessness arrives in labor and states she has not received prenatal care. What is the nurse’s priority action?

An infant is noticeably jaundiced on the third day of life and the parents are concerned.  The nurse explains this to the parents by stating:

CASE STUDY: Use the following Triage Nurses’ Notes to answer the following questions: Nurses Notes 1230: Received phone call from parent of 4-year-old child who is concerned that the child may have experienced a seizure. Parent reports the child had a 12 hour history of runny nose, cough, and fever. Temperature this morning was 40 degrees C (104.0 degrees F). She witnessed the child become unresponsive while sitting in a chair. Child then had rigidity and shaking of arms and legs. Parent is unclear of seizure activity but estimated about 4-7minutes in length. 1235: Additional information obtained from parent is that the child has not taken any antipyretic medication in the last 24 hours. Parent did not think that the child hit their head or experienced any injury during seizure. Parent reports child remains listless and minimally responsive and lying on their side on the floor. Appears to be breathing normally with pink lips. Parent reports child having a febrile seizure at the age of 2 but no other history of seizure. Child takes a multivitamin daily and weighs approximately 36 pounds. Pick 4 Priorities from list below and type in first answer blank: A. Respiratory Status B. Developmental Milestones C. Level of Consciousness D. Birth History E. Medical History F. Eating Habits G. Neurological Status H. Attends Pre School Another Entry into Nurses Note is made: 1240 Parent reports that child did open eyes with minimal movement and is very lethargic. Breathing is stable, axillary temp checked: 39.5 C (103.1 F). Provider diagnosed pt with febrile seizure. Orders obtained: Tylenol 15 mg/kg every 6 hours oral suspension Ibuprofen 10 mg/kg every 8 hours oral suspension Calculate the dosage for both medications and enter your dose (mg) in blank 2. Another entry into Nurses’ Notes is made: 1250: Education provided to parent regarding febrile seizures and treatment plan. Parent reports child is awake and more alert, was able to administer a dose of Tylenol. Child is answering yes/no questions appropriately. Indicate which statements below would indicate parental understanding of teaching of seizures and treatment plan. Place answers in blank 3: A. “I should plan on monitoring my child’s temperature and level of consciousness closely while they are sick.” B. “I should plan on giving my child a Tylenol suppository if they are alert and awake.” C. “My child will need on going anti-seizure medications.” D. “Febrile seizures are most common in kids who are between the ages of 13-18.” E. “My child most likely experienced a febrile seizure and will fully recover.” F. “My child will most likely have a seizure every time they have a fever.”

An otherwise healthy 43-year-old client schedules a visit with their primary physician related to complications from their diabetes. What type of illness is this client experiencing?

The nurse is caring for a Hmong client who presents in labor. What priority assessment questions should be asked that will help develop a plan of care that is culturally appropriate for this client?

A nurse is participating in discharge planning for an infant with the diagnosis of Imbalanced nutrition: less than body requirements r/t poor feeding. The client is committed to breastfeeding the new baby. What resources would it be appropriate to connect the client and infant with prior to discharge?

The client you are caring for has had an epidural placed for pain control during labor. Understanding the potential complications that may accompany epidural placement, what would be the priority nursing intervention?

The client you are caring for has had an epidural placed for pain control during labor. Understanding the potential complications that may accompany epidural placement, what would be the priority nursing intervention?

 A nurse works with families in crisis at a community mental health clinic. What is the best broad definition of a family?