During assessment of a 6-year-old child with meningitis, the ...

[tfester]

During assessment of a 6-year-old child with meningitis, the nurse places the child supine and attempts to put the child's chin on her chest. The child cries out in pain and flexes her knees. How does the nurse document this assessment finding in the medi
 
  A.
  Absent Moro reflex
  B.
  Exaggerated Grey-Turner sign
  C.
  Negative Kernig sign
  D.
  Positive Brudzinski sign

Question 2

A child has been admitted with bacterial meningitis. Which action by the nurse takes priority?
 
  A.
  Administering broad-spectrum antibiotics
  B.
  Assessing and treating pain aggressively
  C.
  Facilitating blood cultures and lumbar puncture
  D.
  Maintaining a quiet, nonstimulating environment

[nekcihc358]

Answer to Question 1

ANS: D
Two assessment tests are used in evaluating a patient with meningitis: the Kernig sign and the Brudzinski sign. The nurse has demonstrated a positive Brudzinski sign. The Kernig sign is elicited by placing the patient supine with hips flexed and raising and straightening the leg. Pain behind the knee and resistance are abnormal findings possibly indicative of meningitis. The Moro reflex is done on infants. The Grey-Turner sign is bruising of the flanks, often accompanying pancreatitis.

Answer to Question 2

ANS: C
All actions are appropriate for the child with acute bacterial meningitis. However, the priority is obtaining cultures so that appropriate therapy can be identified. After cultures are obtained, the nurse will administer broad-spectrum antibiotics until the culture and sensitivity results are known.