A nurse is caring for a school age child who has pertussis.
Which of the following actions should the nurse take?

The correct answer is A. Antibiotics initiated 24 hr ago.

Explanation:

Children with bacterial meningitis require droplet precautions to prevent the spread of infection. These precautions can typically be discontinued after 24 hours of effective antibiotic therapy, as the risk of transmission significantly decreases.

Why the other options are incorrect:

• B. Negative cerebrospinal fluid (CSF) culture – While a negative CSF culture confirms the absence of bacteria, cultures may take several days to process. Droplet precautions are usually lifted based on treatment duration, not pending lab results.

• C. Absent nuchal rigidity – Nuchal rigidity (stiff neck) is a symptom of meningitis, but its resolution does not determine infectious risk.

• D. Temperature below 37.4°C (99.4°F) – Fever reduction is a sign of improvement but does not indicate that the infection is no longer transmissible.

Choice A rationale

While it’s important for a child to have adequate sleep, waiting until the child indicates that they are tired before putting them to bed may not be the best approach. Children often do not recognize their own signs of fatigue and may become overtired, which can actually make it more difficult for them to fall asleep and stay asleep.

Choice B rationale

Allowing a child to watch an animated movie before bedtime may seem like a harmless routine, but it can actually interfere with their sleep. The light from the screen can suppress the production of melatonin, the hormone that regulates sleep, and the content of the movie can be stimulating rather than relaxing.

Choice C rationale

Waking your child up during a night terror can be beneficial. Night terrors occur during the deepest stages of sleep and can be frightening for both the child and the parents. By gently waking your child before the usual time of a night terror, you can interrupt the sleep cycle and potentially prevent the night terror from occurring.

Choice D rationale

While it may be tempting to allow your child to sleep in your bed, especially if they are experiencing night terrors, this is not typically recommended. Co-sleeping can create a dependency and make it more difficult for the child to learn to self-soothe and fall asleep independently.