Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide Example A local daycare had an outbreak of diarrhea, vomiting, and abdominal pain in children. Several babies were found to have clay colored stools in their diapers. One of the mothers took her infant to the pediatrician and testing was performed. The baby was positive for Hepatitis A. One of the daycare employees reported to the health department that a few of the employees did not wash their hands when changing diapers. The health department shut down the daycare and ordered that the administrators do remedial safety courses with the employees. The facility also had to be completely sanitized and all children test negative before they were allowed to reopen. The daycare made it a condition of employment that if any employees were caught not washing their hands, they would be immediately terminated. Signs and symptoms of Hepatitis A: • Malaise • Fatigue • Nausea • Vomiting • Abdominal pain • Headache • Abdominal distention • Anorexia • Right upper quadrant pain • Tea colored urine • Clay colored stools • Jaundice Nursing assessment for Hepatitis A: • Head to toe general assessment o Palpate abdomen for tenderness and guarding o Inquire about intake and output o Perform skin assessment for jaundice o Visual examination for abdominal distention o Auscultate bowel sounds • Ask about recent exposure; daycare, restaurant visits, etc. • Review laboratory reports o CBC with differential o Liver panels with serum transferase levels and liver enzymes; ALT andAST o Blood coagulation testing; PTT and PT o Liver biopsy o HAV immunoassay for IgM antibodies for Hepatitis A virus o Electrolytes o Stool examination o Urinalysis o Abdominal x-ray series

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