The nurse is caring for a 10-year-old who has an acute head injury, has a pediatric Glasgow coma score of 9. and is unconscious. Which interventions should the nurse include in the child's care plan?

A. Allow for adjustment of rules to correlate with the child's behavior.Rules should be consistent and predictable for children with ASD. Frequently changing or “adjusting” rules to match variable behavior increases confusion and anxiety and reduces opportunities to learn expected behaviors.

B. Allow for imaginative play with peers without supervision.
Many children with ASD need structured, supervised social interactions and support to learn play skills, take turns, and interpret social cues. Unsupervised imaginative play may lead to misunderstanding, frustration, or safety issues.

C. Provide a flexible schedule that adjusts to the child's interests.
While incorporating a child’s interests into activities is useful, children with ASD generally do best with a structured, predictable schedule. Sudden flexibility or frequent schedule changes can be disorienting. Best practice: keep a consistent routine but incorporate preferred interests within that structure.

D. Establish a reward system for positive behavior.A reward system (token economy, sticker charts, immediate specific praise) provides clear, consistent, and concrete reinforcement for targeted behaviors. This increases motivation, helps teach expected behaviors, and can be faded gradually as behaviors become routine.

A) Document intake and output:

Documenting intake and output is an important nursing task, but it is not the top priority in a suspected case of bacterial meningitis. Timely administration of antibiotics to treat the infection takes precedence over documentation of intake and output.

B) Administer antibiotics when available.

Explanation:

Bacterial meningitis is a serious and potentially life-threatening infection of the membranes covering the brain and spinal cord. Rapid administration of antibiotics is crucial to effectively treat the infection and prevent its spread. Delay in antibiotic administration can lead to worsening symptoms and complications. Therefore, getting the appropriate antibiotics to the child as soon as they are available is the nurse's priority.

C) Reduce environmental stimuli:

Reducing environmental stimuli can be helpful in managing symptoms and providing comfort to the child with meningitis, but it is not the priority action. The immediate concern in a suspected case of bacterial meningitis is to treat the infection.

D) Maintain seizure precaution:

While maintaining seizure precautions is important, especially if the child has a history of seizures, it is not the top priority in a suspected case of bacterial meningitis. Administering antibiotics to treat the infection and prevent its progression is the primary concern.