A nurse is reviewing the medical record of a 15-month-old child who is scheduled to receive measles, mumps, rubella.
Which of the following findings Should the nurse identify as a contradiction for receiving the vaccine?

Choice A rationale

Administering an antidepressant to the client is an important part of treatment for major depressive disorder. However, it is not the first action the nurse should take.

Choice B rationale

Encouraging the client to attend a group therapy session can be beneficial for the client’s recovery, but it is not the first action the nurse should take.

Choice C rationale

Assisting the client in completing his ADLs can help the client maintain a sense of normalcy and control, but it is not the first action the nurse should take.

Choice D rationale

Asking the client if he is considering harming himself is the first action the nurse should take. This is because safety is the top priority, and the nurse needs to assess the client’s risk for suicide.

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.