A 6-year-old child is admitted to the hospital with suspected bacterial meningitis. What is the nursing priority in the care of this child? Select all that apply.
Ensure the child is placed on droplet precautions.
Encouraging the child to drink plenty of fluids.
Administering intravenous antibiotics as prescribed.
Providing comfort measures such as dimming the lights.
Prepare the child for a CT scan of the head.
Correct Answer : A,C,D
A. Ensure the child is placed on droplet precautions is the priority because bacterial meningitis is highly contagious. Droplet precautions help prevent the spread of the infection to others in the hospital.
B. Encouraging the child to drink plenty of fluids is not the priority in the acute phase of meningitis, as increased fluid intake may not be appropriate, especially if there is elevated intracranial pressure or vomiting. Fluid management should be carefully monitored by the healthcare team.
C. Administering intravenous antibiotics is crucial because bacterial meningitis requires prompt treatment with antibiotics to prevent complications and reduce mortality.
D. Providing comfort measures such as dimming the lights is important because the child may be sensitive to light, noise, and stimuli. A calm, quiet environment can help reduce discomfort and manage symptoms like headache and photophobia.
E. Preparing the child for a CT scan of the head might be indicated if there are signs of increased intracranial pressure, but it is not the immediate priority. Initial treatment with antibiotics and managing the environment are higher priorities.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "We will avoid giving our child any dairy products during an exacerbation." Avoiding dairy products during a Crohn's disease exacerbation is often recommended because many individuals with Crohn's disease are lactose intolerant, and dairy can exacerbate symptoms such as diarrhea.
B. "We will make sure our child eats plenty of fruits and vegetables during an exacerbation." During an exacerbation of Crohn's disease, a high-fiber diet (including many fruits and vegetables) can be problematic, as it may irritate the intestines and worsen symptoms. This statement indicates a need for further teaching.
C. "We will increase our child's intake of high-fiber foods, such as whole grains and legumes." High-fiber foods should generally be avoided during a Crohn's disease flare-up because they can be difficult to digest and may worsen symptoms. However, this advice might be appropriate during periods of remission.
D. "We will encourage our child to drink plenty of fluids, especially water." Hydration is important, particularly during exacerbations, when the risk of dehydration increases due to diarrhea. This is a correct statement.
Correct Answer is C
Explanation
A. Notify the adolescent's primary care provider is incorrect. While it is important to notify the healthcare provider, the immediate priority is performing a thorough assessment to determine the severity of the head injury and any potential complications, such as changes in consciousness or neurological status.
B. Collect a detailed past medical history is incorrect. Although collecting medical history is important, it is not the priority in the acute phase of a suspected head injury. The priority is to assess the current condition of the adolescent, especially signs of deterioration.
C. Perform a thorough assessment noting acute conditions is correct. The priority in suspected head injuries is to perform a thorough assessment to evaluate the patient's neurological status. This includes checking for signs of a concussion, increased intracranial pressure, or any other acute conditions that may require immediate intervention.
D. Administer pain medication to the adolescent is incorrect. Pain management is important, but it should not be the first action when a head injury is suspected, as it can mask symptoms or affect the ability to assess neurological function properly.
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