Which of the following information about a client who has meningococcal meningitis has the best indicator that you can discontinue droplet precautions?
A. Pupils are equal and reactive to light
B. Temperature is lower than 100°F (37.8°C)
C. Appropriate antibiotics have been given for 24 hours
D. Cough is productive of clear, nonpurulent mucus
Correct Answer: C. Appropriate antibiotics have been given for 24 hours.
Current CDC evidence-based guidelines indicate that droplet precautions for clients with meningococcal meningitis can be discontinued when the client has received antibiotic therapy for 24 hours. Antibiotic dose should be given as soon as meningitis is suspected and should not be delayed awaiting confirmatory studies. The other information may indicate that the client’s condition is improving but does not indicate that droplet precaution should be discontinued.
Option A: Meningeal irritability can be confirmed by provocative tests like Kernig and Brudzinski sign. A thorough neurologic exam should be performed looking for alteration in mental status, as well as any focal deficits.
Option B: Older children and adults will present with headaches, fever, photophobia, vomiting, neck stiffness, and altered mental status. Patients can present with abnormal vital signs, including fever, tachypnea, tachycardia, and hypotension. Hypotension with elevated pulse rate is suggestive of early vascular instability.
Option D: The classic triad of neck stiffness, fever, and altered mental status is a more specific sign for meningitis. Infants can present with a variety of non-specific symptoms, which include lethargy, irritability, and in some cases bulging fontanelles.