NR 603 Week 1 Discussion_Viral Meningitis - Naveah Jackson A 7-year-old female

managing the client’s primary and secondary health concerns? Explain your rationale and support it with evidence. Several clinical decision-making considerations factor into the care of complex patients. Patients presenting like Naveah require a comprehensive approach to meet a myriad of complex acute and chronic needs. Factors to consider in the decision-making process specific to Naveah’s situation include the availability of resources, patient family factors, time and cost. When managing the primary health concern of suspected viral meningitis, the patient should be referred to the nearest hospital for a diagnostic lumbar puncture to confirm the diagnosis and rule out other diseases including bacterial meningitis. Additionally, as Naveah and her mother live in a rural area with limited care options, the FNP must stress the importance of a lumbar puncture to differentiate between bacterial and viral meningitis as treatment modalities and prognosis differ greatly. Clinical decision making for secondary health concerns may present more of a challenge as time, finances and resources are limited for Naveah’s mother. The FNP can work with Naveah’s mother and involve members of the interdisciplinary team to help provide a comprehensive care plan to meet Naveah’s complex needs related to her brain injury. This may include the utilization of telehealth services with physicians, in-home occupational, speech and physical therapies, and telehealth meetings with nutritionists, case workers, special educators and child-life specialists. The FNP should coordinate an evaluation to determine if Naveah meets the criteria for in-home specialized nursing care. As Naveah’s mother is a single parent and caretaker to child with complex medical needs, it may be advantageous to refer her to additional support groups and investigate if her insurance includes eligibility for respite care. D. Locate the most current clinical practice guidelines (CPG) for the client’s primary and secondary diagnoses. Considering your assigned client’s situation and the current CPGs, what is your recommended management plan? Explain your rationale and support it with evidence. When considering the most recent CPGs for Naveah’s primary diagnosis of viral meningitis the recommended management plan should include blood cultures, a lactic acid, and a lumbar puncture with CSF analysis (Mount & Boyle, 2017). Once viral meningitis is identified the patient should be provided with standard supportive care including fluids, optimal nutrition, adequate rest and antipyretics. In light of the complexity of Naveah’s history, hospitalization may be required to reduce complications including seizures, cerebral edema and SIADH (Cantu & Das, 2023). Additionally, empiric IV antibiotics may be given when waiting for a bacterial meningitis rule out and IV antivirals may be given empirically if encephalopathy is suspected (Cantu & Das, 2023). When considering the most recent CPGs for Naveah’s secondary diagnosis of anoxic brain injury with associated neurological deficits, treatment should include coordinated care from an interprofessional team. The FNP should refer Naveah to clinicians experienced in the management of brain injuries and who are proficient in recognizing and managing associated complications (Lacerte, Shapshak, & Mesfin, 2023). Furthermore, Naveah should be referred to skilled nursing care to prevent complications from immobility, as