A nurse is assessing a client who reports a severe headache and stiff neck. The nurse’s assessment reveals positive Kernig’s and Brudzinski’s signs. Which of the following actions should the nurse perform first?
Decrease bright lights.
Implement droplet precautions.
Initiate IV access.
Administer antibiotics.
The Correct Answer is B
Choice A reason:
Decreasing bright lights can help alleviate discomfort for the client, especially if they are experiencing photophobia, which is common in meningitis. However, this action does not address the immediate need to prevent the spread of infection. While it is a supportive measure, it is not the first priority in managing a client with suspected meningitis.
Choice B reason:
Implementing droplet precautions is the first priority when a client presents with symptoms suggestive of meningitis, such as a severe headache, stiff neck, and positive Kernig’s and Brudzinski’s signs. Meningitis can be caused by bacterial infections that are highly contagious and spread through respiratory droplets. Initiating droplet precautions helps prevent the transmission of the infection to other clients and healthcare workers, making it the most critical initial action.
Choice C reason:
Initiating IV access is important for administering medications and fluids, but it is not the first priority. Ensuring the safety of others by implementing droplet precautions takes precedence. Once precautions are in place, the nurse can proceed with establishing IV access to facilitate further treatment.
Choice D reason:
Administering antibiotics is crucial in the treatment of bacterial meningitis, but it should be done after droplet precautions are in place to prevent the spread of infection. Prompt antibiotic therapy is essential, but the initial step must focus on infection control measures to protect others from exposure.
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Correct Answer is B
Explanation
Choice A reason:
The use of antibiotics to fight infections significantly improved health outcomes and reduced mortality rates from bacterial infections. However, antibiotics were not widely available until the mid-20th century. The dramatic increase in life expectancy began earlier, largely due to improvements in public health measures.
Choice B reason:
Sanitation and other public health activities were most responsible for the dramatic increase in life expectancy during the twentieth century. Improvements in sanitation, such as clean water supply, sewage treatment, and waste disposal, drastically reduced the incidence of infectious diseases. Public health initiatives, including vaccination programs and health education, also played a crucial role in preventing disease and promoting health.
Choice C reason:
Technology increases in the field of medical laboratory research have contributed to advancements in medical knowledge and treatment. While these technological advancements have improved diagnostic capabilities and treatment options, they were not the primary drivers of the initial increase in life expectancy during the early 20th century.
Choice D reason:
Advances in surgical techniques and procedures have significantly improved outcomes for many medical conditions. However, these advances primarily benefited individuals who had access to surgical care and did not have as widespread an impact on overall life expectancy as public health measures did.
Correct Answer is B
Explanation
Choice A reason:
Restricting drinking fluids before and during meals is not an appropriate suggestion for improving nutritional status. While it might help prevent early satiety in some cases, it does not address the underlying issues related to Myasthenia gravis, such as muscle weakness affecting chewing and swallowing.
Choice B reason:
Planning medication doses to occur before meals is a crucial strategy for clients with Myasthenia gravis. Medications such as anticholinesterase agents can help improve muscle strength, making it easier for the client to chew and swallow food. This approach can enhance the client’s ability to consume adequate nutrition during meals.
Choice C reason:
Increasing the amount of fat and carbohydrates in meals might help with caloric intake, but it does not address the specific challenges faced by clients with Myasthenia gravis. The focus should be on strategies that improve the client’s ability to eat effectively, rather than just altering the macronutrient composition of meals.
Choice D reason:
Eating three large meals per day can be challenging for clients with Myasthenia gravis due to muscle fatigue. Smaller, more frequent meals are often recommended to help manage energy levels and ensure adequate nutrition without overwhelming the client.