PGIMER Sangrur NO - 2023
Child Health Nursing (Pediatrics)
Hard
A 4-month-old with meningococcal meningitis has just been admitted to the pediatric unit. Which nursing intervention has the highest priority?
Appeared in: PGIMER Sangrur NO - 2023
Explanation
- Meningococcal meningitis is a severe bacterial infection caused by Neisseria meningitidis, which is highly contagious.
- The organism spreads through respiratory droplets, making immediate isolation a critical safety measure.
- In nursing, the principle of safety (for the patient and others) is the highest priority, superseding comfort measures and routine admission tasks.
- Droplet precautions must be initiated immediately upon suspicion or confirmation of the diagnosis to prevent transmission to other patients, staff, and visitors.
Why Other Options Were Wrong
- Option B: Managing fever with acetaminophen is a secondary priority. While important for comfort and to reduce metabolic demand, it does not address the immediate life-threatening risk of disease transmission.
- Option C: Gathering a detailed history is part of the assessment phase but must be deferred until immediate safety measures, like isolation, are implemented.
- Option D: Orienting the parents to the unit is a routine, low-priority task that can be performed once the patient is stabilized and critical safety interventions are in place.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Prioritization of nursing interventions for a pediatric patient with a communicable disease to guide bedside assessment, documentation, and the next nursing action.
- The core principle tested is 'Safety First.' For any highly contagious disease, the nurse's immediate responsibility is to implement infection control measures to protect everyone in the healthcare environment.
- Failure to promptly isolate a patient with meningococcal meningitis can lead to a hospital-acquired outbreak, posing a significant risk to other vulnerable patients, especially in a pediatric unit.
- What if? If the diagnosis was viral meningitis instead of meningococcal, droplet precautions would likely not be the highest priority (unless a specific contagious virus like influenza was the cause). The focus would shift more immediately to supportive care, such as fluid management and pain control, as most viral meningitis is less transmissible.
How to Approach the Question
- First, identify the key information in the question: a 4-month-old infant, a diagnosis of meningococcal meningitis, and the need to determine the 'highest priority' nursing intervention.
- Recognize that 'highest priority' questions in nursing require you to apply principles of safety, such as the ABCs (Airway, Breathing, Circulation) or infection control.
- Recall the pathophysiology of meningococcal meningitis. It is a severe bacterial infection transmitted via respiratory droplets, making it highly contagious.
- Evaluate each option based on the principle of safety. Option A, 'Ready droplet precautions,' directly addresses the risk of transmission and is a critical safety measure.
- Compare the urgency of the other options. Administering acetaminophen (comfort), obtaining history (assessment), and orienting parents (routine care) are all important but are secondary to preventing the spread of a life-threatening infection.
- Conclude that initiating droplet precautions is the most critical and immediate action to ensure the safety of the patient and the entire unit.
Concept Tested & Keywords
- Concept Tested: Prioritization of nursing interventions for a pediatric patient with a communicable disease.
- Stem keywords: 4-month-old, meningococcal meningitis, pediatric unit, highest priority
- Lead-in keywords: highest priority
- Clinical cues: Diagnosis of meningococcal meningitis is a critical cue indicating a highly contagious condition requiring immediate infection control.
- Clinical cues: The patient's age (4-month-old infant) highlights vulnerability to rapid deterioration.
Question ID
QpOQ2PRG2EIhAnx-SW3YPB
Reference Book
E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 2 (pp 239-476 of 713) p. 216-218
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1644-1646
Practise the full PGIMER Sangrur NO - 2023
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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