A nurse is planning care for a client who is experiencing seizures secondary to meningitis. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

Place a tongue blade at the bedside.

Dim the overhead lights.

Assist the client to ambulate every 4 hr.

Apply a warming blanket.

Have suction equipment at the bedside.

Answer and Explanation

Correct Answer : B,E

A. Place a tongue blade at the bedside: Keeping a tongue blade at the bedside is not recommended because attempting to insert an object into the mouth during a seizure can cause injury to the teeth, gums, or airway. Instead, the focus should be on maintaining a safe environment and protecting the client from harm.

B. Dim the overhead lights: Meningitis can cause photophobia, or sensitivity to light, which can worsen discomfort and potentially trigger seizures. Dimming the lights helps reduce sensory stimulation and promotes comfort, decreasing the risk of further neurological agitation.

C. Assist the client to ambulate every 4 hr: Clients experiencing seizures should have activity restrictions to prevent falls and injuries. Ambulation should be supervised and only encouraged once the client is stable. Frequent rest is preferred to minimize exhaustion, which can contribute to seizure activity.

D. Apply a warming blanket: Meningitis can cause fever, but applying a warming blanket is not appropriate unless the client is experiencing hypothermia. Fever management typically involves antipyretics and cooling measures, such as tepid sponge baths or light clothing, rather than warming interventions.

E. Have suction equipment at the bedside: During a seizure, excessive secretions or impaired airway protection can lead to aspiration. Having suction equipment readily available allows for quick clearance of the airway once the seizure subsides, reducing the risk of respiratory complications.

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Correct Answer is C

Explanation

A. Genital herpes: Herpes simplex virus (HSV) is a common sexually transmitted infection, but it is not a nationally notifiable disease. Reporting is not mandatory in most jurisdictions, although counseling and partner notification are recommended.

B. Varicella zoster: Chickenpox (primary varicella infection) is reportable in some states, but herpes zoster (shingles) is generally not required to be reported. However, outbreaks in certain settings, such as schools or healthcare facilities, may need notification.

C. Tuberculosis: Tuberculosis is a highly contagious airborne disease that requires mandatory reporting to public health authorities. Reporting ensures contact tracing, outbreak control, and public health interventions to prevent further transmission.

D. Clostridium difficile: While Clostridium difficile infections are of significant concern in healthcare settings, they are not universally reportable to the local health department. Infection control measures are implemented within facilities, but routine reporting is not always required.

A. "The surgeon will make a small incision in your abdomen." B. "You may experience referred shoulder pain." C. "Your procedure will be scheduled during menstruation." D. "Warm saline will be instilled via the cervix."

Correct Answer is B

Explanation

A. "The surgeon will make a small incision in your abdomen.": A hysterosalpingography is a fluoroscopic imaging procedure that does not require surgical incisions. Contrast dye is injected through the cervix to visualize the uterus and fallopian tubes.

B. "You may experience referred shoulder pain.": Referred shoulder pain is a common side effect due to peritoneal irritation caused by the contrast dye if it spills into the peritoneal cavity, particularly when the fallopian tubes are patent. This discomfort is temporary and resolves on its own.

C. "Your procedure will be scheduled during menstruation.": The test is typically scheduled after menstruation but before ovulation (days 7-10 of the cycle) to ensure the uterus is clear of blood and to avoid disrupting an early pregnancy.

D. "Warm saline will be instilled via the cervix.": Hysterosalpingography uses iodine-based contrast dye for X-ray imaging, not warm saline. Saline infusion is used in sonohysterography, which is an ultrasound-based procedure.

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A nurse is planning care for a client who is experiencing seizures secondary to meningitis. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

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