A 7-year-old child with suspected poliomyelitis presents with fever, headache, and progressive muscle weakness…

Question

A 7-year-old child with suspected poliomyelitis presents with fever, headache, and progressive muscle weakness in the lower extremities, starting 3 days ago with flu-like symptoms. The child is admitted to the pediatric unit, and the physician has ordered isolation precautions. Which nursing intervention should be the priority during the acute phase of the illness?

Accepted Answer

보기 1: Maintain strict contact and droplet precautions with proper isolation techniques

Strict isolation precautions are the priority to prevent transmission via respiratory droplets and fecal-oral routes during the acute phase. Other interventions like exercise or corticosteroids are not appropriate initially.

Answer

보기 2: Encourage active range of motion exercises to prevent muscle atrophy

Answer

보기 3: Administer high-dose corticosteroids to reduce inflammation

Answer

보기 4: Position the child in Trendelenburg position to improve circulation

Concept	Key Points
Poliomyelitis (Polio)	Acute viral infection affecting the anterior horn cells of the spinal cord and brainstem, leading to flaccid paralysis. Transmission: Fecal-oral (primary), respiratory droplets (early phase).
Isolation Precautions (CDC Guidelines)	Contact & Droplet Precautions: Use gown/gloves for contact with patient or environment. Use surgical mask for close contact. Emphasize hand hygiene. Enteric precautions for incontinent patients.
Nursing Process & Priorities	1. Safety/Infection Control 2. Symptom Management (fever, pain) 3. Monitoring for Complications (respiratory failure) 4. Rehabilitation (in recovery phase).
Phases of Polio	Acute/Paralytic Phase: Viral replication, symptom onset, potential paralysis. Priority: Isolation, support. Recovery/Convalescent Phase: 2+ years post-acute. Priority: Physical therapy, prevent deformities.

Intervention	Acute Phase (Priority: Containment & Support)	Recovery/Convalescent Phase (Priority: Rehabilitation)
Infection Control	Key Point! STRICT Contact & Droplet Precautions. Top priority.	Precautions may be discontinued once viral shedding stops (confirmed by lab).
Activity/Exercise	Absolute rest. Affected limbs should be supported in neutral position. Avoid active exercise and fatigue.	Gradual, passive then active exercises. Physical therapy to maximize function, prevent contractures and atrophy.
Positioning	Proper alignment, support with pillows. Avoid Trendelenburg.	Therapeutic positioning, splinting to prevent foot drop or other deformities.
Medication Focus	Analgesics (for pain/myalgia), antipyretics. No role for corticosteroids.	Pain management for post-polio syndrome (if it develops years later).

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