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Which of the following complications should the nurse identify as being potential risks for this child? Select all that apply.

A.

Laryngospasm

B.

Hydrocephalus

C.

Demyelination

D.

Seizures

E.

Subdural effusions

F.

Hearing loss

G.

Guillain-Barré syndrome

Answer and Explanation

Correct Answer : B,D,E,F

Rationale for Correct Answers:

  • Hydrocephalus: Inflammation of the meninges can block cerebrospinal fluid (CSF) flow, leading to ventricular dilation and hydrocephalus, a known complication of bacterial meningitis.
  • Seizures: Meningeal irritation and increased intracranial pressure can cause seizures. Children with altered mental status and fever are at heightened risk.
  • Subdural effusions: These may develop due to inflammation and accumulation of fluid between the dura and arachnoid layers, often seen in pediatric meningitis cases.
  • Hearing loss: Sensorineural hearing loss may result from inflammation or damage to the auditory nerve or cochlea. It’s a well-documented sequela of meningitis.

Rationale for Incorrect Choices:

  • Laryngospasm: Typically associated with airway irritation or hypocalcemia, not a common or expected complication of meningitis.
  • Demyelination: More commonly linked to conditions like multiple sclerosis. Meningitis does not typically cause demyelination of neurons.
  • Guillain-Barré syndrome: An autoimmune condition often triggered by viral illness, not by meningitis. It involves peripheral nervous system demyelination, unrelated to this case.


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Related Questions

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

Explanation

  • Seizures: Bacterial meningitis causes inflammation and irritation of the brain's meninges, increasing the risk of seizures as the brain becomes more excitable. Seizures are a common serious complication and require close monitoring and prompt treatment.
  • Increased intracranial pressure: Inflammation from meningitis can cause cerebral edema, leading to increased intracranial pressure (ICP). Elevated ICP can worsen neurological status and cause brain herniation if untreated, making it a critical complication to watch for.

Rationale for Incorrect Choices:

  • Hypothermia: This child presents with fever Temperature 38.7° C (101.7° F), which is typical in bacterial meningitis; hypothermia is not a common risk in this condition.
  • Disseminated intravascular coagulation (DIC): Although DIC can occur in severe sepsis, it is less common early in meningitis and not the greatest immediate risk. Additionaly the child has a normal platelet count 350,000/mm³ making DIC unlikely currently.
  • Hydrocephalus: Hydrocephalus can develop as a late complication due to blockage of cerebrospinal fluid flow but is less immediate than seizures and increased ICP.

Correct Answer is ["A","C","D","F"]

Explanation

A. Capillary refill of 4 seconds is prolonged and indicates poor perfusion, which is a sign of worsening dehydration or possible shock. This requires immediate follow-up.

B. Hyperactive bowel sounds are expected in a toddler with diarrhea and do not indicate immediate deterioration.

C. Cool extremities suggest poor circulation and possible hypovolemia or shock, requiring urgent assessment.

D. Absence of tears is a classic sign of dehydration in a toddler and indicates worsening fluid deficit that needs prompt intervention.

E. Diaper area redness is common with diarrhea and indicates skin irritation, but it is not a priority compared to signs of dehydration or shock.

F. Lethargy is a concerning neurologic change and may indicate severe dehydration or decreased perfusion, requiring immediate attention.

G. Heart rate of 112/min is within expected range for a toddler and does not indicate acute deterioration.

H. Respiratory rate of 26/min is within normal limits for a toddler and is not a priority concern.

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