A nurse is planning to administer an ophthalmic medication to a client. Which of the following actions will minimize systemic absorption of the medication?

A. Oral irrigating device: An oral irrigating device is used for oral hygiene but is not a priority for a client with bacterial meningitis. Infection control and safety interventions take precedence over routine hygiene equipment upon admission.

B. Seizure pads: Clients with bacterial meningitis are at risk for increased intracranial pressure and seizures due to inflammation of the meninges. Placing seizure pads on the bed helps prevent injury if a seizure occurs, ensuring client safety during acute illness.

C. Sterile gloves: Standard precautions require the use of clean gloves for routine care. Sterile gloves are necessary only for invasive procedures, not for general admission care, so they are not a priority item for the room setup.

D. Tongue blade: A tongue blade is used for throat examinations but is not essential for immediate care of a client with bacterial meningitis. Priority interventions focus on monitoring neurologic status and preventing complications such as seizures.

• Muscle guarding: Muscle guarding is a classic sign of peritoneal irritation, most commonly seen in acute appendicitis. Rebound tenderness and right lower quadrant pain strongly support inflammation of the appendix. Guarding occurs as the abdominal muscles contract to protect inflamed underlying tissue. It is not typically associated with celiac disease and is less characteristic of uncomplicated diverticulitis.
• Increased temperature: Fever reflects an inflammatory or infectious process and is commonly seen in appendicitis and diverticulitis. Both conditions involve localized infection that can progress if untreated. The client’s rising temperature supports acute abdominal inflammation. Celiac disease is an autoimmune condition and does not usually present with fever.
• Nausea and vomiting: Nausea and vomiting frequently accompany appendicitis due to visceral irritation and inflammation. These symptoms can also occur in diverticulitis as a result of bowel inflammation and decreased motility. In contrast, celiac disease more commonly presents with chronic diarrhea and malabsorption rather than acute vomiting.
• Abdominal pain: Abdominal pain is present in all three conditions but differs in character and location. Appendicitis typically causes right lower quadrant pain, while diverticulitis often presents with left lower quadrant pain. Celiac disease can cause diffuse abdominal discomfort related to gluten exposure and malabsorption.
• Elevated WBC count: An elevated white blood cell count indicates an acute inflammatory or infectious process, which is characteristic of appendicitis and diverticulitis. Leukocytosis reflects the body’s immune response to bacterial infection or tissue inflammation. Celiac disease does not typically cause leukocytosis because it is a chronic autoimmune condition rather than an acute infection.