A nurse is assisting with the development of an inservice about viral and bacterial meningitis. The nurse should include that the introduction of which of the following immunizations decreased the incidence of bacterial meningitis?
Haemophilus Influenza Type B (HIB) Vaccine and TDAP
Inactivated polio vaccine (IPV) and Pneumococcal Conjugate Vaccine (PCV)
DTAP and Varicella Vaccine
Pneumococcal Conjugate Vaccine (PCV) and Haemophilus Type B (HIB Vaccine)
The Correct Answer is D
A. Haemophilus Influenza Type B (HIB) Vaccine and TDAP. HIB vaccine reduces the incidence of meningitis caused by Haemophilus influenzae, but TDAP does not target pathogens responsible for meningitis.
B. Inactivated polio vaccine (IPV) and Pneumococcal Conjugate Vaccine (PCV). IPV prevents polio but has no impact on meningitis incidence. PCV is correct for preventing Streptococcus pneumoniae meningitis.
C. DTAP and Varicella Vaccine. DTAP does not prevent bacterial meningitis, and varicella vaccine prevents chickenpox, not meningitis.
D. Pneumococcal Conjugate Vaccine (PCV) and Haemophilus Type B (HIB Vaccine). These vaccines directly prevent bacterial meningitis caused by Streptococcus pneumoniae and Haemophilus influenzae, which were previously leading causes of meningitis in children.
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Correct Answer is A
Explanation
A. "Give her acetaminophen, not aspirin.": Aspirin is contraindicated in children due to the risk of Reye's syndrome, a rare but serious condition that affects the liver and brain, especially during viral illnesses like the flu or chickenpox. Acetaminophen is a safer alternative for fever management in children.
B. "You'll have to call your physician.": While seeking physician advice is important, the nurse has a duty to provide accurate, immediate, evidence-based guidance to prevent harm.
C. "Give her no more than three baby aspirin every 4 hours.": Recommending aspirin dosing is unsafe due to the risk of Reye's syndrome.
D. "Follow the directions on the aspirin bottle for her age and weight.": Providing this advice without addressing safety concerns is inappropriate and potentially harmful.
Correct Answer is B
Explanation
A. Depressed anterior fontanel: A depressed fontanel is typically associated with dehydration, not meningitis.
B. High-pitched cry: A high-pitched cry is a classic symptom of meningitis in infants, often associated with increased ICP.
C. Constipation: Meningitis is more likely to cause irritability and feeding difficulties than constipation.
D. Presence of the rooting reflex: The rooting reflex is normal in a 4-month-old and does not specifically indicate meningitis.