A nurse in the emergency department is caring for a child who has a temperature of 39.1° C (102.4° F) and a suspected diagnosis of bacterial meningitis.
Which of the following actions should the nurse take first?
A.
Prepare the child for a lumbar puncture.
B.
Dim the lights in the child’s room.
C.
Administer an antipyretic to the child.
D.
Implement droplet precautions for the child.
The correct answer and Explanation is :
In the scenario where a child with a suspected diagnosis of bacterial meningitis is presenting with a fever of 39.1°C (102.4°F), the nurse’s first priority should be:
D. Implement droplet precautions for the child.
Explanation:
Bacterial meningitis is a serious infection that affects the protective membranes covering the brain and spinal cord. It is commonly spread through respiratory droplets from coughing or sneezing. Therefore, implementing droplet precautions is crucial to prevent the spread of the infection to other patients and healthcare staff.
Here’s a breakdown of why the other options are not the immediate priorities:
- A. Prepare the child for a lumbar puncture: While a lumbar puncture (LP) is important for diagnosing bacterial meningitis by analyzing cerebrospinal fluid (CSF), it is not the first step. The procedure involves collecting CSF to confirm the diagnosis, but before this, it is essential to ensure the safety of both the patient and others by minimizing the risk of transmission.
- B. Dim the lights in the child’s room: This action can be beneficial in managing symptoms such as photophobia (sensitivity to light) which is common in meningitis. However, it is not as urgent as implementing infection control measures to prevent the spread of the disease.
- C. Administer an antipyretic to the child: Reducing fever with an antipyretic (like acetaminophen or ibuprofen) can help in managing the child’s symptoms and providing comfort. However, controlling the risk of transmission takes precedence, as the infection can quickly spread if appropriate precautions are not in place.
Implementing droplet precautions involves using a mask when in close contact with the patient, ensuring the patient wears a mask if they need to leave their room, and maintaining proper hand hygiene. This measure is critical in protecting others from contracting bacterial meningitis, making it the first action the nurse should take.