A nurse is assessing a client who is experiencing opioid withdrawal. Which of the following findings should the nurse expect?

A. "Bacterial meningitis can be prevented with immunization": Vaccines such as the meningococcal, pneumococcal, and Haemophilus influenzae type b (Hib) vaccines significantly reduce the risk of bacterial meningitis. Immunization is a primary preventive measure, especially for high-risk populations, including children, adolescents, and certain adults.

B. "Bacterial meningitis is an infection that causes inflammation of the sinus cavity.": Bacterial meningitis causes inflammation of the meninges, which are the protective membranes covering the brain and spinal cord, not the sinuses. Confusing the site of infection can lead to inappropriate assessment and treatment.

C. "Bacterial meningitis is spread by contaminated food or water; therefore, infection is unlikely": This statement is incorrect because bacterial meningitis is typically spread through respiratory droplets, close contact, or asymptomatic carriers, not through food or water.

D. "Bacterial meningitis rarely occurs in young adults unless their immune system is suppressed.": Young adults, particularly those in communal settings like college dorms or military barracks, are at increased risk regardless of immune status. Immunocompetent individuals can still acquire bacterial meningitis.

A. Orientation: The client is alert only to name and not fully oriented, indicating acute neurological changes. This requires immediate follow-up to assess for possible stroke or other neurological compromise.

B. Breath sounds: Breath sounds are vesicular and bronchovesicular with full thoracic excursion, which is within normal limits. No follow-up is immediately required.

C. Gag reflex: The absence of a gag reflex is a significant finding, increasing the risk of aspiration and airway compromise. Immediate assessment and interventions are necessary to protect the airway.

D. Pupils: Pupils are equal and reactive bilaterally, which is within normal limits. No follow-up is required for this finding.

E. Extremity circulation: Pulses are +2 with capillary refill less than 2 seconds in all extremities, indicating adequate perfusion. No follow-up is needed at this time.

F. Speech: The client’s speech is unintelligible, indicating acute neurological compromise. This requires urgent follow-up and possible intervention for stroke or transient ischemic attack.

G. Grip strength: Decreased grip strength in the right upper extremity indicates motor deficits consistent with neurological injury, requiring immediate assessment and intervention.

H. Thoracic findings: Full and symmetric thoracic excursion with normal breath sounds is within normal limits, requiring no follow-up.

I. Heart sounds: S1 and S2 are present, and the cardiac monitor shows sinus tachycardia without additional abnormalities, which does not require immediate follow-up.