The nurse is developing an activity plan for a client. The nurse should recognize that which activity plan would best conserve the client's energy without compromising physical or mental health?

Choice A reason: Administering an antipyretic is not the next action that the nurse should initiate because it does not address the priority problem of potential brain damage or death caused by meningococcal meningitis, which is a bacterial infection of the meninges that can rapidly progress to septic shock or disseminated intravascular coagulation.

Choice B reason: Decreasing environmental stimuli is not the next action that the nurse should initiate because it does not address the priority problem of potential brain damage or death caused by meningococcal meningitis, which can impair the function of the central nervous system and cause increased intracranial pressure, seizures, coma, or cranial nerve palsies.

Choice C reason: Assessing the cranial nerves is the next action that the nurse should initiate because it can provide vital information about the extent and severity of brain involvement caused by meningococcal meningitis, which can affect any or all of the 12 pairs of cranial nerves that control sensory and motor functions of the head and neck.

Choice D reason: Completing a vascular assessment is not the next action that the nurse should initiate because it does not address the priority problem of potential brain damage or death caused by meningococcal meningitis, which can cause inflammation and damage of blood vessels in various parts of the body, leading to ischemia, necrosis, or gangrenE.

In this scenario, the sudden regurgitation and cyanosis in a 24-hour-old infant indicate a potential airway obstruction or compromise. The immediate priority is to clear the airway and ensure adequate ventilation.

Suctioning the oral and nasal passages helps remove any potential obstruction or mucus that may be causing the cyanosis. This intervention aims to restore normal airflow and prevent further respiratory distress in the infant.

Let's briefly evaluate the other options:

a) Turn the infant onto the right side.

Positioning the infant onto the right side does not directly address the potential airway obstruction or cyanosis. While positioning may have some benefit in certain situations, such as facilitating drainage, it is not the most appropriate immediate intervention in this case.

c) Give oxygen by positive pressure.

Administering oxygen by positive pressure may be necessary if the infant's oxygen saturation remains low after suctioning and clearing the airway. However, suctioning should be the initial intervention to address any potential airway obstruction or mucus before considering oxygen administration.

d) Stimulate the infant to cry.

Stimulating the infant to cry is not the appropriate intervention in this case. It does not directly address the potential airway obstruction or cyanosis. Crying requires a patent airway, and if the infant is already cyanotic, it suggests an obstruction or inadequate ventilation. Therefore, suctioning and clearing the airway take precedence over stimulating the infant to cry.

In summary, when a full-term, 24-hour-old infant in the nursery regurgitates and suddenly turns cyanotic, the practical nurse should immediately suction the oral and nasal passages to clear any potential airway obstruction or mucus. This intervention aims to restore normal airflow and ensure adequate ventilation for the infant.