Which interventions would the nurse include in the plan of care for a patient with a diagnosis of bacterial meningitis?

Maintain the patient in a flat, supine position

Restrain the patient in bed.

Reduce the patient's environmental stimuli as much as possible

Increase the patient's fluid intake

Answer and Explanation

The Correct Answer is C

A.   A flat supine position is not recommended for patients with meningitis; they should be kept at a 30- degree angle to reduce ICP.

B.   Restraining the patient is unnecessary unless there is an immediate risk of harm, and it can cause distress.
C.   Reducing environmental stimuli helps minimize discomfort and risk of seizures, especially in meningitis, which causes hypersensitivity to light and sound.
D.   Fluid intake should be monitored carefully. Excessive fluids may increase ICP in a patient with meningitis.

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Correct Answer is A

Explanation

A. Shivering is a common response to cold therapy (such as a hypothermia blanket) as the body attempts to maintain its core temperature. This can increase metabolic demands and oxygen consumption, which should be closely monitored.
B. Seizures are not typically associated with the use of hypothermia blankets unless there are underlying conditions that predispose to them.
C. Dehydration could occur with any prolonged therapy but is not the immediate concern with hypothermia blankets.
D. Burns are rare but could occur if the hypothermia blanket is not properly managed. Shivering is a more immediate concern.

A. An ICP of 10 mm HG B. An ICP of 15 mm HG C. An ICP of 20 mm HG D. An ICP of 5 mm HG

Correct Answer is C

Explanation

A. An ICP of 10 mm HG is within normal limits.
B. An ICP of 15 mm HG is within normal limits.
C. An ICP of 20 mm Hg is elevated and should be reported immediately as it can indicate worsening conditions like brain swelling or herniation. Normal ICP is typically 5 to 15 mm Hg.
D. An ICP of 5 mm HG is also normal and would not require immediate reporting.

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Which interventions would the nurse include in the plan of care for a patient with a diagnosis of bacterial meningitis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has meningitis, a temperature of 39.7° C (103.5° F), and is prescribed a hypothermia blanket. While using this therapy, the nurse should know that the client must carefully be observed for which of the following complications?

Correct Answer is A

Explanation

For the patient after a craniotomy, which intracranial pressure (ICP) reading would the nurse report immediately to the healthcare provider?

Correct Answer is C

Explanation

A nurse admits a client who has a subarachnoid hemorrhage and increased intracranial pressure (ICP). Which of the following medications should the nurse expect to administer to decrease ICP?

A nurse is preparing to administer an osmotic diuretic IV to a client with increased intracranial pressure. Which of the following should the nurse identify as the purpose of the medication?

A nurse is assessing a client who has meningitis and notes when passively flexing the client's neck there is an involuntary flexion of both legs. Which of the following conditions is the client displaying?

A nurse is planning care for a client 1 day postoperative following a detached retinal repair. Which of the following instructions should the nurse include in the plan?

A nurse is caring for a client who has increased intracranial pressure. Which of the following interventions should the nurse plan to include in the plan of care? (Select All that Apply.)

A nurse caring for a client who had a right-sided stroke and is exhibiting homonymous hemianopsia when eating. Which of the following actions should the nurse take?

Which initial clinical manifestation would a patient report with a retinal detachment?

when assessing a patient's neurologic status upon arrival to the emergency room, which reliable indicator would the nurse utilize first?