# A nurse is caring for a patient with suspected bacterial meningitis. Which nursing action should be the highest priority? > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=541244 > language: ko > subject: Adult Health ## 문제 A nurse is caring for a patient with suspected bacterial meningitis. Which nursing action should be the highest priority? ## 보기 1. Implement droplet precautions immediately **✔ 정답** 2. Administer prescribed analgesics for headache relief 3. Obtain vital signs and neurological assessment 4. Prepare the patient for lumbar puncture **정답: 1** ## 해설 Droplet precautions are the highest priority to prevent transmission of suspected bacterial meningitis, which is highly contagious via respiratory droplets. Other actions like pain management, assessment, and diagnostic preparation are important but secondary to infection control. ## 심화 해설 Clinical Priority Setting in Suspected Bacterial Meningitis When a patient presents with suspected bacterial meningitis, the nurse must immediately recognize that this is a medical emergency requiring rapid, systematic intervention. The highest priority action is to implement droplet precautions immediately. This decision is grounded in the fundamental principle of infection control and safety, which takes precedence over all other interventions to protect healthcare workers, other patients, and the community. The rationale for this prioritization is clearly supported by evidence-based perioperative guidelines. The updated AORN guideline for transmission-based precautions provides critical direction for managing patients with confirmed or suspected infectious diseases [1]. Bacterial meningitis pathogens, such as Neisseria meningitidis and Haemophilus influenzae type b, are transmitted via large respiratory droplets. The guideline explicitly outlines strategies to reduce the risk of transmission, which includes the immediate implementation of droplet precautions upon suspicion of the disease [1]. This involves placing the patient in a private room, having staff wear a surgical mask for all close contact within 3 feet of the patient, and having the patient wear a mask during transport. Delaying this action, even to perform a brief neurological assessment, exposes the nurse and others to a significant risk of a potentially fatal infection. While the other listed actions are essential components of care, they are secondary to ensuring a safe environment. Obtaining vital signs and a neurological assessment is crucial for establishing a baseline and monitoring for complications like increased intracranial pressure, but it can be performed immediately after initiating precautions. Administering analgesics for headache relief addresses a comfort need, but does not address the immediate safety risk of disease transmission. Preparing the patient for a lumbar puncture is a critical diagnostic step, as cerebrospinal fluid analysis is required for definitive diagnosis; however, this procedure requires preparation and a provider's order and is not the nurse's first independent action upon suspicion. The nurse's immediate, independent, and highest-priority intervention is to initiate transmission-based precautions, a core nursing responsibility for containing infectious threats [1].References (research sources) - [1]Guidelines in Practice: Transmission-Based Precautions.GuidelineMarr J. (2025) · DOI: 10.1002/aorn.14411 ## 임상 시나리오 Immediate Droplet Precautions for Suspected MeningitisPrioritizing infection control to prevent transmission of Neisseria meningitidis Upon suspicion of bacterial meningitis, implement droplet precautions immediately. Place the patient in a private room and don a surgical mask before entering a 3-foot radius. This safety measure takes precedence over all other assessments or interventions, including neurological checks and pain management, to protect healthcare workers and other patients. CautionEnsure the patient wears a surgical mask during transport. Delaying isolation, even briefly, significantly increases the risk of exposure to a potentially fatal infection. ## 핵심 개념 - **Droplet Precautions** — Infection control measures used for diseases transmitted via large respiratory droplets, requiring a private room and a surgical mask for close contact within 3 feet. - **Bacterial Meningitis** — An acute inflammation of the meninges caused by bacteria such as Neisseria meningitidis, often presenting as a medical emergency requiring prompt isolation and treatment. - **Neisseria meningitidis** — A gram-negative diplococcus bacterium that is a leading cause of bacterial meningitis and is transmitted through respiratory and throat secretions. - **Priority Setting** — A clinical decision-making process that ranks patient problems and interventions using frameworks like the ABCs or safety/infection control hierarchy. ## 같은 주제 문제 - [A nurse is assessing a 28-year-old patient admitted with suspected bacterial meningitis. 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