A nurse is reinforcing teaching about controlling allergens with the parent of a child who has a new diagnosis of asthma. Which of the following instructions should the nurse include?

Choice A rationale:
Decreased white blood cells (WBCs) in cerebrospinal fluid (CSF) would not support the diagnosis of bacterial meningitis. In bacterial meningitis, the presence of bacteria triggers an inflammatory response, leading to an increase in WBCs in the CSF (pleocytosis).
Choice B rationale:
Elevated glucose levels in CSF would actually be more consistent with viral rather than bacterial meningitis. In bacterial meningitis, glucose levels are typically decreased due to the high metabolic demands of bacteria on the glucose present in the CSF.
Choice C rationale:
Elevated total protein in cerebrospinal fluid (CSF) is indicative of inflammation and disruption of the blood-brain barrier. Bacterial meningitis causes an intense inflammatory response, leading to an increase in total protein in the CSF.
Choice D rationale:
Decreased pressure in the CSF would not be a characteristic finding in bacterial meningitis. In fact, bacterial meningitis often leads to an increase in CSF pressure due to the inflammation and accumulation of inflammatory cells and proteins.

Choice A rationale:
Placing a toddler in a side-lying position on the affected side after administering otic medication is not recommended. This position can cause the medication to leak out, reducing its effectiveness, and can also increase the risk of infection. It's important to keep the medication in the ear canal for an adequate amount of time to allow it to work properly.
Choice B rationale:
Allowing the medication to reach room temperature prior to administration is not a critical step for otic medications. While warming certain medications can reduce discomfort, this is not a specific requirement for ear drops. Ensuring the cleanliness of the ear, proper positioning, and correct administration technique are more important.
Choice C rationale:
The correct choice. Sitting the child in an upright position is the recommended approach for administering otic medication. This position helps ensure that the medication remains in the ear canal and is not immediately expelled. It also facilitates better penetration of the medication into the ear canal, increasing its effectiveness.
Choice D rationale:
Gently pulling a child's ear upward is a technique used for administering otic medications to straighten the ear canal and allow better access to the medication. However, this step alone is not sufficient. Proper positioning of the child is equally important to prevent the medication from leaking out.