A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions is unnecessary in the client's plan of care?
Measure head circumference every shift
Admit the client to a private room
Place the client in a semi-Fowler's position
Implement seizure precautions
The Correct Answer is A
A. While monitoring for increased intracranial pressure is important, measuring head circumference every shift may not be necessary unless there is a specific indication or change in the child's condition.
B. Admitting the child to a private room is necessary to reduce the risk of spreading the infection to others.
C. Placing the child in a semi-Fowler's position can help reduce intracranial pressure and promote comfort.
D. Implementing seizure precautions is important, as children with bacterial meningitis are at risk for seizures.
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Related Questions
Correct Answer is D
Explanation
A. Sleep apnea is different from SIDS; SIDS is a sudden, unexplained death during sleep in otherwise healthy infants.
B. SIDS rates have actually been decreasing due to public health campaigns promoting safe sleep practices.
C. There is no direct correlation between SIDS and diphtheria, tetanus, and pertussis vaccines.
SIDS is a multifactorial event, and vaccines have not been shown to cause it.
D. Placing infants on their back to sleep is a key recommendation for reducing the risk of SIDS, as per safe sleep guidelines endorsed by healthcare organizations.
Correct Answer is D
Explanation
A. Rovsing's sign is a rebound tenderness felt in the right lower quadrant when the left lower quadrant is palpated. It may be positive in acute appendicitis but is not indicative of perforation.
B. A low-grade fever is common in acute appendicitis but may not necessarily indicate perforation.
C. A sudden decrease in abdominal pain may indicate perforation, but it is not a definitive sign.
Perforation can lead to a temporary relief of pain as the irritants spread throughout the peritoneum.
D. A flaccid abdomen (soft and lacking muscular tension) can be a sign of peritonitis, which may occur due to perforation of the appendix. It suggests irritation of the peritoneum and is a more significant concern than a localized infection.
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