A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions is unnecessary in the client's plan of care?
Measure head circumference every shift
Admit the client to a private room
Place the client in a semi-Fowler's position
Implement seizure precautions
The Correct Answer is A
A. While monitoring for increased intracranial pressure is important, measuring head circumference every shift may not be necessary unless there is a specific indication or change in the child's condition.
B. Admitting the child to a private room is necessary to reduce the risk of spreading the infection to others.
C. Placing the child in a semi-Fowler's position can help reduce intracranial pressure and promote comfort.
D. Implementing seizure precautions is important, as children with bacterial meningitis are at risk for seizures.
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Related Questions
Correct Answer is B
Explanation
A. Breastfeeding is an option for infants with gastroesophageal reflux. It does not necessarily require a switch to formula feeding.
B. Keeping the baby in an upright position after feedings helps prevent gastroesophageal reflux by allowing gravity to assist in keeping stomach contents down.
C. Thickening formula with oatmeal is a potential intervention for infants with gastroesophageal reflux, but this is not the primary recommendation in this scenario.
D. Positioning the baby side-lying during sleep can increase the risk of aspiration and is not recommended. The baby should be placed on the back to sleep to reduce the risk of sudden infant death syndrome (SIDS).
Correct Answer is B
Explanation
A. Blood cultures are important in the diagnostic workup for bacterial meningitis, but the priority is to obtain cerebrospinal fluid through a lumbar puncture for definitive diagnosis.
B. A lumbar puncture is a priority in suspected bacterial meningitis to assess the cerebrospinal fluid for signs of infection and to guide appropriate treatment.
C. Administering an intravenous antibiotic is an important intervention, but the lumbar puncture takes precedence for confirming the diagnosis.
D. Placing the child in isolation is important for preventing the potential spread of infection, but the immediate diagnostic priority is the lumbar puncture.
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