A nurse is caring for a child who has bacterial meningitis. Which of the following findings should indicate to the nurse that the child can be removed from droplet precautions?
Absent nuchal rigidity
Negative cerebrospinal fluid culture
Antibiotics initiated 24 hr ago
Temperature below 37.4° C (99.3° F)
The Correct Answer is B
A. Absent nuchal rigidity is a positive sign in the context of managing bacterial
meningitis, but it alone does not determine when droplet precautions can be discontinued.
B. This is the correct answer. A negative cerebrospinal fluid (CSF) culture indicates that the bacterial infection has been effectively treated. Once the CSF culture is negative, the child is no longer considered contagious and can be removed from droplet precautions.
C. The initiation of antibiotics is an important step in treating bacterial meningitis, but the passage of time alone does not indicate when precautions can be discontinued. The
effectiveness of treatment is better determined by laboratory and clinical indicators.
D. The temperature is an important clinical parameter, but a temperature below 37.4° C (99.3° F) alone does not determine when droplet precautions can be discontinued. The decision is based on the resolution of the infectious process, as indicated by negative cultures.
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Related Questions
Correct Answer is B
Explanation
A. A child with impetigo has a contagious skin infection. It would not be appropriate to room them with a preschooler who has just had surgery, as this could increase the risk of post-operative infection.
B. Correct. A child with a fractured left femur does not have a contagious condition that would pose a risk to the preschooler following Wilms' tumor removal. This would be an appropriate roommate.
C. A child with viral pneumonia has a contagious respiratory infection. This could put the preschooler at risk of developing a respiratory infection, which could be especially dangerous after surgery.
D. A child with cellulitis of the right radius has a contagious skin infection. It would not be appropriate to room them with a preschooler who has just had surgery, as this could increase the risk of post-operative infection.
Correct Answer is A
Explanation
A. Increased restlessness can indicate hypoxia, pain, or worsening shock, which are critical concerns in a toddler with significant burns. This finding should be reported immediately.
B. Respiratory rate of 25/min is within the normal range for a toddler (22-37 breaths per minute) and does not require immediate intervention.
C. Bowel sounds of 20/min are normal and do not indicate a complication.
D. Urinary output of 35 mL/hr is adequate for a toddler (goal: ≥1-2 mL/kg/hr, which would be ≥20-40 mL/hr for a 20 kg child) and does not require reporting.
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