A nurse is providing care to a pediatric patient diagnosed with Haemophilus influenzae type b meningitis. Which additional preventive measure should the nurse recommend?

Choice A rationale:

Nuchal rigidity (stiff neck) is a classic symptom of meningitis, but it is not particularly concerning in older adults as it is in younger individuals. Older adults may have a less pronounced neck stiffness due to age-related changes.

Choice B rationale:

Rash can be a symptom of certain types of meningitis, such as meningococcal meningitis, but it is not specific to older adults. Moreover, older adults may not exhibit a rash even in cases of meningococcal meningitis.

Choice C rationale:

Irritability is a vague symptom and may not be specific to meningitis in older adults. It can be caused by various factors and does not raise significant concern for meningitis.

Choice D rationale:

Altered mental status, such as confusion, delirium, or decreased level of consciousness, is particularly concerning in older adults with suspected meningitis. Older adults may not always present with classic symptoms like neck stiffness, and altered mental status may be the primary indicator of central nervous system involvement.

Choice E rationale:

Photophobia is a common symptom of meningitis, but it is not specific to older adults. It may be present in both younger and older patients with meningitis.

Choice A rationale:

Antibiotic therapy for the family members is not the most appropriate preventive measure for Haemophilus influenzae type b meningitis. While antibiotics are used to treat the infection, providing antibiotic therapy to family members does not prevent the spread of the bacteria to others.

Choice B rationale:

Prophylaxis for the patient's close contacts is the recommended preventive measure for Haemophilus influenzae type b meningitis. Close contacts of a patient with this type of meningitis, such as household members and daycare contacts, are at an increased risk of contracting the disease. Administering prophylactic antibiotics to these individuals can help prevent the transmission of the bacteria and reduce the likelihood of developing the infection.

Choice C rationale:

Hygiene education for school staff and students is not directly related to preventing the spread of Haemophilus influenzae type b meningitis. While hygiene education is essential for preventing the spread of infections in general, it is not specific to this particular type of meningitis.

Choice D rationale:

Outbreak management protocols for the community may be necessary if there is an outbreak of Haemophilus influenzae type b meningitis. However, this choice does not address the immediate preventive measure needed for the diagnosed pediatric patient and their close contacts.

Choice E rationale:

Vaccination against Neisseria meningitidis is not directly relevant to preventing Haemophilus influenzae type b meningitis. These are two different types of bacteria that cause different forms of meningitis, and vaccination against Neisseria meningitidis would not protect against Haemophilus influenzae type b meningitis.