A nurse is delegating tasks to the assistive personnel (AP). The nurse should direct the AP to complete which of the following tasks first?

Choice A reason: Administering an antipyretic is not the next action that the nurse should initiate. An antipyretic is a medication that lowers fever, which is a common symptom of meningococcal meningitis. However, fever is not a life-threatening condition, and it may have some beneficial effects on fighting infection. The nurse should first prioritize other actions that are more urgent or critical for the client's safety and outcome.

Choice B reason: Decreasing environmental stimuli is not the next action that the nurse should initiate. Decreasing environmental stimuli is a nursing intervention that can help reduce agitation, confusion, or seizures in clients with meningococcal meningitis. However, it is not an immediate or essential action, and it may not be effective if the client's condition worsens or progresses to coma.

Choice C reason: Assessing the cranial nerves is the next action that the nurse should initiate. Cranial nerve assessment is a neurological examination that evaluates the function of 12 pairs of nerves that originate from the brainstem and control various sensory and motor functions, such as vision, hearing, smell, taste, facial expression, eye movement, swallowing, speech, and balance. Meningococcal meningitis is an inflammation of the meninges, which are the membranes that cover and protect the brain and spinal cord. Meningeal inflammation can compress or damage the cranial nerves, causing various signs and symptoms, such as headache, photophobia, diplopia, facial palsy, dysphagia, dysarthria, or nystagmus. Assessing the cranial nerves can help detect any neurological deficits or complications early, and guide appropriate interventions or referrals.

Choice D reason: Completing a vascular assessment is not the next action that the nurse should initiate. A vascular assessment is a physical examination that evaluates the blood flow and circulation in different parts of the body, such as the arms, legs, abdomen, or neck. It may include checking pulses, blood pressure, capillary refill, skin color, temperature, or edema. A vascular assessment may be relevant for some clients with meningococcal meningitis who develop septic shock or disseminated intravascular coagulation (DIC), which are serious conditions that affect blood vessels and clotting factors. However, these are not common or early manifestations of meningococcal meningitis, and they require more advanced or specialized assessments and treatments.

Choice A reason: Scheduling energy-intensive activities at the time of day when the client has higher energy levels is the best activity plan for conserving the client's energy without compromising physical or mental health, as it allows the client to perform the tasks that require more effort and endurance when they feel more alert and capable. This can help the client to avoid fatigue, frustration, and injury, and to achieve their goals more effectively. The nurse should assess the client's individual preferences and patterns of energy fluctuation, and help them to prioritize and plan their activities accordingly.

Choice B reason: Scheduling all activities within a small block of time to allow the client a longer, uninterrupted rest period is not a good activity plan for conserving the client's energy without compromising physical or mental health, as it may cause the client to overexert themselves and deplete their energy reserves. This can lead to exhaustion, pain, and stress, and impair the client's recovery and quality of life. The nurse should advise the client to balance their activities with adequate rest periods throughout the day and to avoid doing too much or too little at once.

Choice C reason: Scheduling toilet breaks before and after any other planned activity is not a good activity plan for conserving the client's energy without compromising physical or mental health, as it may not be realistic or feasible for some clients. Some clients may have urinary or bowel problems that require them to use the toilet more frequently or urgently, such as incontinence, infection, or constipation. Forcing them to follow a rigid schedule may cause them discomfort, embarrassment, or complications. The nurse should assess the client's elimination needs and habits, and help them to manage their toileting needs in a comfortable and convenient way.

Choice D reason: Scheduling the client's hygiene activities and limiting visitors is not a good activity plan for conserving the client's energy without compromising physical or mental health, as it may neglect the client's social and emotional needs. Hygiene activities are important for maintaining the client's physical health and well-being, but they can also be tiring and challenging for some clients. Limiting visitors may reduce the noise and stimulation in the environment, but it can also isolate the client from their family and friends who can provide support and companionship. The nurse should assist the client with their hygiene needs as needed, and encourage them to interact with their visitors as tolerated.