Nursing Prioritization Delegation Assignment Q 64
The nurse is assigned to a client with meningococcal meningitis. Which information about the client is the best indicator that the nurse can discontinue droplet precautions?
A. Appropriate antibiotics have been given 24 hours
B. Cough is productive of clear, nonpurulent mucus
C. Pupils are equal and reactive to light
D. Temperature is lower than 100°F (37.8°C)
Correct Answer: A. Appropriate antibiotics have been given 24 hours
Contemporary CDC evidence-based guidelines indicate that droplet precautions for clients with meningococcal meningitis can be discontinued when the client has received antibiotic therapy (with drugs that are effective against Neisseria meningitidis) for 24 hours.
Option B: The patient with suspected or confirmed N. meningitidis should follow droplet precaution. This should be continued until after 24 hours of effective antibiotics administration. Meningococcal meningitis is a medical emergency presenting with severe sepsis syndrome, fever, petechiae, and ecchymosis requiring prompt resuscitation and antibiotic administration.
Option C: A thorough neurologic exam should be performed looking for alteration in mental status, as well as any focal deficits. The classic triad of neck stiffness, fever, and altered mental status is a more specific sign for meningitis. Infants can present with a variety of non-specific symptoms, which include lethargy, irritability, and in some cases bulging fontanelles.
Option D: The other information may mean that the client’s condition is improving but does not mean that droplet precautions should be stopped. Patients can present with abnormal vital signs, including fever, tachypnea, tachycardia, and hypotension. Hypotension with elevated pulse rate is suggestive of early vascular instability.