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Exhibits

For each potential nursing intervention, click to specify if the intervention is indicated or not indicated for the child. There must be at least 1 selection in every row. There does not need to be a selection in every column.

A.

Administer broad-spectrum antibiotics.

B.

Implement isolation precautions.

C.

Assist with a lumbar puncture.

D.

Administer an antipyretic

E.

Encourage ambulation

F.

Provide external stimulation.

G.

Initiate seizure precautions

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"B"},"G":{"answers":"A"}}

  • Administer broad-spectrum antibiotics: Prompt initiation of antibiotics is critical in suspected bacterial meningitis to prevent rapid progression and reduce neurological complications. Treatment should begin even before culture results return. Delay in treatment increases the risk of morbidity and mortality.
  • Implement isolation precautions: Droplet precautions should be initiated immediately due to the possibility of meningococcal meningitis, which is highly contagious. These precautions protect healthcare staff and other patients. Isolation continues until 24 hours after antibiotics are started.
  • Assist with a lumbar puncture: Lumbar puncture is a primary diagnostic tool to confirm meningitis and identify the pathogen in cerebrospinal fluid. It helps guide targeted antibiotic therapy. This should be done after initiating antibiotics if there's no contraindication.
  • Administer an antipyretic: Fever increases metabolic demand and can worsen neurologic symptoms like seizures or confusion. Antipyretics like acetaminophen help reduce fever and improve comfort. Controlling temperature also stabilizes cardiovascular and respiratory effort. This supports overall treatment goals.
  • Encourage ambulation: The child is lethargic, photophobic, and has altered mental status, making ambulation unsafe and unnecessary. Activity can increase intracranial pressure or fall risk. Rest is important during acute neurologic illness. Mobility is not a priority until the child stabilizes.
  • Provide external stimulation: Children with meningitis often experience neurologic hypersensitivity and irritability. External stimulation, such as bright lights or loud noises, can worsen symptoms. A calm, quiet environment is needed to reduce distress. Limiting stimulation aids in neurologic recovery.
  • Initiate seizure precautions: Meningitis increases the risk of seizures due to inflammation of the brain and elevated temperature. Altered mental status and photophobia further heighten this risk. Seizure precautions include padded side rails and having emergency medications ready. Safety preparation is essential.


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Related Questions

Correct Answer is B

Explanation

A. No head lag when pulled into a sitting position: By 2 months, some head lag may still be present when pulling the infant to a sitting position. Full control of the head without lag typically develops closer to 4 months of age.

B. Lifts head 45° when lying prone: At 2 months, infants generally can lift and hold their head at about a 45-degree angle when placed on their stomach. This demonstrates early neck muscle strength and control appropriate for this age.

C. Rolls over from abdomen to back: Rolling over usually occurs later, around 4 to 6 months. It is not an expected gross motor milestone for a 2-month-old infant.

D. Rolls over from back to abdomen: This is a more advanced motor skill that typically develops between 5 to 6 months of age and would not be expected at 2 months.

Correct Answer is A

Explanation

A. "I will increase my food intake before I exercise.": This indicates understanding, as additional carbohydrates may be needed before physical activity to prevent exercise-induced hypoglycemia. Adolescents with type 1 diabetes must learn to balance insulin, food intake, and activity.

B. "As long as I take my insulin, I can eat whatever I want.": Insulin helps manage blood glucose, but dietary choices still matter. Consuming high-sugar or high-fat foods can lead to poor glycemic control, even with insulin administration.

C. "As I get older, my sugar levels will automatically decrease.": Blood glucose levels do not automatically improve with age. Diabetes management remains essential throughout life and often requires adjustments during puberty due to hormonal changes.

D. "The blood pressure medicine I'm taking will help to keep my insulin level low.": Antihypertensives do not regulate insulin levels. Insulin therapy must be managed separately, and medications for blood pressure address cardiovascular risk, not glycemic control.

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