A nurse is caring for a newly admitted client who has bacterial meningitis. Which of the following actions should the nurse take?

Monitor the client for hypoglycemia.

Implement seizure precautions.

Place the client in high-Fowler’s position.

Administer antiviral medications.

Answer and Explanation

The Correct Answer is B

Choice A reason: Monitoring for hypoglycemia is not a priority in bacterial meningitis, as it is not a common complication. The focus is on neurological risks like seizures or increased intracranial pressure due to inflammation. This action diverts attention from critical interventions, making it inappropriate for managing meningitis.
Choice B reason: Implementing seizure precautions is essential for bacterial meningitis, as inflammation of the meninges can irritate the brain, increasing seizure risk. Precautions like padded bed rails and anticonvulsant readiness ensure safety and prompt response, aligning with evidence-based care for this condition, making it the correct action.
Choice C reason: Placing the client in high-Fowler’s position may increase discomfort or exacerbate intracranial pressure in bacterial meningitis. A 30-degree head elevation is preferred to reduce pressure while maintaining comfort. This position is not optimal, making it an incorrect choice for this condition.
Choice D reason: Administering antiviral medications is inappropriate, as bacterial meningitis requires antibiotics, not antivirals, which target viral infections. Misusing antivirals delays effective treatment and worsens outcomes, making this action incorrect and potentially harmful for managing bacterial meningitis.

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Correct Answer is B

Explanation

Choice A reason: Attaching restraints to movable side rails is unsafe, as rail movement can cause injury or loosen restraints. They should be secured to the bed frame, a fixed structure, so this guideline is incorrect and dangerous for restraint protocols.
Choice B reason: Documenting the client’s condition every 15 minutes ensures frequent monitoring for safety, circulation, and skin integrity, per CMS and Joint Commission standards. This prevents complications and supports timely restraint removal, making it the correct guideline.
Choice C reason: Requesting PRN restraint prescriptions is inappropriate, as restraints require specific, time-limited orders based on immediate need. PRN orders lack oversight and risk misuse, so this guideline is incorrect and non-compliant with regulations.
Choice D reason: Applying restraints over clothing can cause discomfort or skin irritation, as direct skin contact with padding is preferred for safety. This guideline is incorrect, as proper application minimizes harm, making it inappropriate for protocols.

A. Anuria B. Edema C. Hyperkalemia D. Hypocalcemia E. Metabolic acidosis

Correct Answer is ["A","B","C","D","E"]

Explanation

Choice A reason: Anuria, minimal or no urine output, is expected in end-stage kidney disease (ESKD) due to nephron loss, reducing glomerular filtration rate. This causes fluid and toxin buildup, requiring dialysis to manage fluid balance and prevent complications like uremia in ESKD clients.
Choice B reason: Edema results from impaired sodium and water excretion in ESKD, causing fluid overload. Reduced filtration leads to volume retention, manifesting as peripheral or pulmonary edema, increasing cardiovascular strain and necessitating diuretics or dialysis to control fluid status effectively.
Choice C reason: Hyperkalemia occurs in ESKD, as failing kidneys cannot excrete potassium, elevating serum levels. This risks cardiac arrhythmias due to disrupted membrane potentials. Dietary restrictions or dialysis are needed to manage potassium, preventing life-threatening complications in end-stage renal failure.
Choice D reason: Hypocalcemia in ESKD stems from impaired vitamin D activation and phosphate retention, binding calcium. This disrupts bone mineralization and neuromuscular function, causing tetany or fractures. Calcium supplementation and dialysis correct this imbalance, addressing renal failure’s metabolic consequences.
Choice E reason: Metabolic acidosis in ESKD results from impaired hydrogen ion excretion and bicarbonate reabsorption. This lowers blood pH, causing fatigue and bone demineralization. Dialysis or bicarbonate therapy corrects acid-base imbalances, addressing the kidneys’ failure to maintain homeostasis in end-stage disease.

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