Answer to Question 1
ANS: D
Shock is a serious complication of meningitis, and the patient's low blood pressure indicates the need for interventions such as fluids or vasopressors. Nuchal rigidity and a positive Kernig's sign are expected with bacterial meningitis. The nurse should intervene to lower the temperature, but this is not as life threatening as the hypotension.
Answer to Question 2
ANS: B
Calculate the cerebral perfusion pressure (CPP): (CPP = mean arterial pressure MAP ICP). MAP = DBP + 1/3 (systolic blood pressure SBP diastolic blood pressure DBP). Therefore the (MAP) is 70 and the CPP is 56 mm Hg, which is below the normal of 60 to 100 mm Hg and approaching the level of ischemia and neuronal death. Immediate changes in the patient's therapy such as fluid infusion or vasopressor administration are needed to improve the cerebral perfusion pressure. Adjustments in the head elevation should only be done after consulting with the health care provider. Continued monitoring and documentation will also be done, but they are not the first actions that the nurse should take.
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Deliver abdominal thrusts to the supine unconscious patient.
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The nurse begins the general survey