The nurse has reviewed the Provider Prescriptions on the day of discharge.

Exhibits

The nurse has provided information regarding the adolescent's medication for home use to the guardian and the adolescent. Select the 2 statements that demonstrate the guardian's understanding of the adolescent's medication.

Rationale for correct choices:

• Seizures: Clients with meningitis are at risk for seizures due to meningeal irritation, high fever, and increased intracranial pressure. Neurological complications arise as the infection spreads within the central nervous system, disrupting electrical activity in the brain.

• Level of consciousness: The adolescent is lethargic, drowsy, and irritable when aroused, which reflects altered neurological status. This finding indicates cerebral involvement, which increases the likelihood of seizure activity as the illness progresses.

Rationale for incorrect choices:

• Lyme disease: This condition is caused by tick bites and typically presents with erythema migrans rash, arthralgia, and fatigue, not acute fever, photophobia, or purpuric rash as seen here.

• Pneumonia: Respiratory involvement would present with abnormal breath sounds, cough, or hypoxemia, but this client has clear lung sounds and normal oxygen saturation, making pneumonia unlikely.

• Mononucleosis: This condition usually causes fever, pharyngitis, and lymphadenopathy, but the client’s cervical nodes are normal and their presentation aligns more with meningitis.

• Constipation: Gastrointestinal complications such as constipation are not relevant here since bowel sounds are active, the abdomen is soft, and there are no reports of decreased stooling.

• Abdominal findings: The abdomen is soft, flat, and with normal bowel sounds, which provides no evidence of an abdominal complication linked to meningitis risk.

• Rash: While the purpuric rash supports the diagnosis of meningococcal meningitis, it is not the primary indicator of seizure risk. Neurological status is a stronger predictor of seizure development.

• Cervical lymph nodes: These are normal without edema or tenderness, ruling out lymphatic involvement as a significant concern in this scenario.

• Breath sounds: Breath sounds are clear and equal bilaterally, which excludes a respiratory complication such as pneumonia as the risk factor linked to seizures.

A. Desquamation: Skin peeling or desquamation is an acute side effect of radiation therapy, typically appearing during or shortly after treatment, not years later.

B. Nausea: Nausea is also an acute effect that commonly occurs during radiation therapy, especially when the gastrointestinal tract or brain is involved. It is not considered a late effect years after treatment.

C. Mucosal ulceration: Ulceration of the mucous membranes is an early complication related to radiation affecting rapidly dividing cells. It resolves after treatment and is not a late manifestation.

D. Short stature: Radiation therapy in young children can damage growth plates and affect hormone production, leading to growth delays and short stature. This is a recognized late adverse effect seen years after treatment.