A nurse is contributing to the plan of care for a client who has viral meningitis. Which of the following interventions should the nurse recommend?
Measure the client's intake and output every 8 hr.
Dim the lighting in the client's room.
Monitor the client's temperature every 6 hr.
Initiate contact precautions for the client.
The Correct Answer is B
Choice A Reason:
Measuring the client's intake and output every 8 hours is a general nursing intervention but might not be specifically pertinent to managing viral meningitis.
Choice B Reason:
Dim the lighting in the client's room is correct. Meningitis often causes sensitivity to light (photophobia) due to the inflammation of the meninges surrounding the brain and spinal cord. Dimming the lighting in the client's room helps reduce discomfort and sensitivity to light, which is a common symptom of meningitis.
Choice C Reason:
Monitoring the client's temperature every 6 hours is a routine nursing practice, but in viral meningitis, more frequent temperature monitoring might be necessary, especially if the client shows signs of fever or instability.
Choice D Reason:
Initiating contact precautions for viral meningitis is not typically necessary because it's usually transmitted through respiratory secretions. Standard precautions for infection control, including proper hand hygiene, are usually sufficient.
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Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Speech therapists, also known as speech-language pathologists, specialize in evaluating and treating swallowing difficulties (dysphagia) among other speech and language issues. They are trained to assess and provide therapies to improve swallowing function, ensuring safe and effective swallowing to prevent aspiration and related complications.
Choice B Reason:
Respiratory therapists primarily focus on the respiratory system and breathing issues. While they play a crucial role in managing respiratory problems, their expertise generally centers around respiratory treatments, ventilator management, and pulmonary function testing. They might assist if dysphagia leads to aspiration and subsequent respiratory complications, but the primary management of dysphagia itself falls within the scope of a speech therapist.
Choice C Reason:
Occupational therapists assist individuals in regaining independence in daily activities. While they may help with certain aspects of dysphagia management, their primary focus isn't specifically on evaluating and treating swallowing disorders. They might address related issues, such as adapting eating utensils or positioning during meals to assist the client, but they may not have the specialized training needed for direct dysphagia therapy.
Choice D Reason:
Physical therapists primarily focus on improving mobility, strength, and physical function. While they might address certain issues related to oral motor function or posture during eating that could affect swallowing, their expertise lies more in physical rehabilitation rather than the specialized treatment of dysphagia.
Correct Answer is D
Explanation
Choice A Reason:
Ensure the blinds in the client's room remain open is not appropriate. Bright light can contribute to sensory overload. It's better to create a subdued and calming environment, so keeping the blinds closed or partially closed might help reduce excess stimuli.
Choice B Reason:
Place the client in a room near the nurses' station is not appropriate. Being near the nurses' station could increase the noise and activity around the client, potentially worsening sensory overload. It's advisable to place the client in a quieter area away from high-traffic zones to minimize auditory and visual stimulation.
Choice C Reason:
Play quiet music in the client's room is incorrect. While soothing music might help some individuals relax, for someone experiencing sensory overload, even low-volume music could add to the stimuli. Silence or minimal ambient noise might be more beneficial.
Choice D Reason:
Break up nursing care into small, frequent sessions is correct. This action is beneficial for managing sensory overload. Breaking up care into smaller sessions allows for adequate rest periods between activities, reducing the overall sensory input at any given time.
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