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A nurse is admitting an 8-year-old child to the pediatric unit.

The nurse suspects the child has bacterial meningitis.

Drag words from the choices below to fill in each blank in the following sentence.

The child is at greatest risk for developing 

and.
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"D"}

Rationale for correct choices

• Increased intracranial pressure: Bacterial meningitis can cause inflammation of the meninges and cerebral edema, leading to increased intracranial pressure (ICP). The child’s symptoms—headache, nausea, nuchal rigidity, irritability, and lethargy—are indicative of meningeal irritation and potential early ICP. Monitoring for ICP is critical to prevent complications such as brain herniation and neurologic deterioration.

• Seizures: Inflammation and increased pressure in the central nervous system can precipitate seizures in children with bacterial meningitis. Elevated WBC count indicates active infection, which can disrupt normal neuronal function. Early identification and management of seizures are essential to minimize neurological damage and ensure patient safety.

Rationale for incorrect choices

• Hydrocephalus: Hydrocephalus may develop as a late complication of bacterial meningitis due to impaired cerebrospinal fluid absorption, but it is not the most immediate risk. The current presentation focuses on acute neurological compromise rather than chronic fluid accumulation.

• Disseminated intravascular coagulation: While DIC can occur with severe sepsis, there is no current evidence of coagulopathy, abnormal bleeding, or thrombocytopenia in this child. The immediate concern is neurological rather than hematologic complications.

• Hypothermia: The child is febrile (38.7° C / 101.7° F), making hypothermia unlikely. Fever is a hallmark of bacterial infection, and hypothermia would be inconsistent with the current presentation.


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Related Questions

Correct Answer is B

Explanation

A. Apply firm pressure to the wound base while removing the gauze dressing: Applying firm pressure can disrupt newly formed granulation tissue and increase pain and bleeding. This approach may delay wound healing and cause unnecessary trauma, especially in pediatric clients.

B. Saturate the gauze dressing with sterile saline solution prior to removing it: Moistening the dressing with sterile saline helps loosen adhered gauze from the wound bed. This reduces tissue trauma, minimizes pain, and preserves healthy granulation tissue during dressing removal.

C. Continue to remove the gauze dressing by pulling it parallel to the skin: Pulling the dressing, even parallel to the skin, can still tear fragile tissue if the gauze is stuck. This method does not address the issue of the gauze being stuck to the internal wound bed.and may worsen wound injury.

D. Irrigate the wound with half-strength hydrogen peroxide while removing the gauze dressing: Hydrogen peroxide is cytotoxic to healthy tissue and can impair wound healing. Its use is generally avoided for routine wound care and is not appropriate for loosening an adhered dressing.

Correct Answer is C

Explanation

A. "Let me explain the consequences of not having this surgery.": While providing information about risks and benefits is important, this approach can come across as pressuring or judgmental. It does not validate the parent's feelings or ensure their concerns are addressed before the provider intervenes.

B. "You have already signed the consent form for surgery.": This statement can make the parent feel dismissed or coerced, undermining trust. Consent is an ongoing process, and parents have the right to reconsider or ask questions at any point before surgery.

C. "I will notify the provider of your concerns about this surgery.": Notifying the provider respects the parent's autonomy and ensures that their concerns are addressed by the appropriate healthcare professional. It supports open communication, promotes shared decision-making, and ensures informed consent is maintained.

D. "You have the best cardiovascular surgical team.": Offering reassurance about the surgical team may seem supportive, but it does not address the parent's uncertainty or provide an avenue for resolving their concerns. Emotional validation and provider involvement are more appropriate in this context.

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