Pediatrics Question #20
Which prescription for a 7-month-old patient with bacterial meningitis should the nurse perform
- Administer cefotaxime mg IVPB every 12 hours.
- Place the child on seizure precautions during hospital stay.
- Place the child in a private room with minimal stimuli.
- Obtain a baseline head circumference and monitor daily.
The correct answer is A. Bacterial meningitis is a medical emergency. The delay of antimicrobial agents (cefotaxime) can have adverse effects on mortality and cause neurological deficits. Seizures may result due to swelling and pressure in the brain but is not the priority intervention at this time. The child with bacterial meningitis will be placed on droplet precautions (private room, mask) until 24 hours of antibiotic therapy is completed. Minimal stimuli is suggested to avoid cerebral irritation however this does not take priority over timely antibiotic therapy. Increased intracranial pressure (ICP) can cause a bulging fontanel or increased head circumference. Obtaining this data and monitoring is important and in the plan of care. It is not the first priority.
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