A nurse is attending to a client experiencing hypovolemic shock.

What findings should the nurse anticipate?

Choice A rationale
A DNR prescription does not mean that the patient will only receive pain medication for their treatments. A DNR order simply means that if the patient’s heart stops beating or they stop breathing, medical staff will not attempt resuscitation3.
Choice B rationale
A DNR prescription does not necessarily limit a patient’s current treatment regimen. It only specifies that CPR will not be performed in the event of cardiac or respiratory arrest. Other treatments can still be provided based on the patient’s wishes and the medical team’s recommendations3.
Choice C rationale
A DNR prescription allows a patient to continue with their current treatment regimen. The DNR order only comes into effect if the patient’s heart stops or they stop breathing3.
Choice D rationale
While a DNR prescription may limit the ability to receive invasive procedures in the event of cardiac or respiratory arrest, it does not limit other forms of treatment. The patient can still receive treatments that align with their goals of care3.

Based on the provided exhibits, the client is most likely experiencingBacterial Meningitis. This is indicated by symptoms such as severe headache, fever, sensitivity to light, nuchal rigidity, and the presence of Neisseria meningitidis in the cerebrospinal fluid with elevated white blood cell count and lactic acid levels.

The two actions the nurse should take to address this condition are:

1. Anticipate administering antibiotic therapy- This is crucial as the client’s culture and sensitivity test indicates the presence of Neisseria meningitidis, which requires antibiotic treatment.
2. Place the client on droplet precautions- Since Neisseria meningitidis can be spread through respiratory droplets, it is important to implement droplet precautions to prevent the spread of infection.

The two parameters the nurse should monitor to assess the client’s progress are:

1. Level of consciousness- Monitoring for changes in the client’s level of consciousness can indicate the effectiveness of the treatment and the progression of the disease.
2. Increased intracranial pressure- Signs of increased intracranial pressure can include changes in vital signs, level of consciousness, and the presence of headache or vomiting. Monitoring these signs is important in the management of bacterial meningitis.