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                                                                                     Care plan

A case of Stephanie Brown, a 3-year-old female with a history of spastic cerebral 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. At the age of 6 months, Stephanie Brown was diagnosed with cerebral palsy when her provider noted that she had persistent and asymmetric tonic neck reflex. She also has spasticity of her lower extremities. At present, she has mildly impaired strength and movement in her upper extremities with some spasticity. She has tight heel cords. Her leg strength is mild to moderately impaired, and she has mild spasticity with movement. She wears ankle-foot orthotics. Stephanie Brown’s mother indicated that she does some exercises and treatments and strategies at home. A number of things in Stephanie Brown’s history might have contributed to her cerebral palsy. She was born at 27 weeks gestation. Her mother had intermittent bleeding during her pregnancy that she did not report. She also smoked during much of her pregnancy, quitting late. Stephanie Brown was born with the umbilical cord around her neck and had Apgar scores of 3 and 4. She was in the NICU and received oxygen. Make a detailed care plan for this patient.

SCIENCE
HEALTH SCIENCE
NURSING
PEDIATRIC NURSING PNP124

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