A nurse is admitting a child who has bacterial meningitis. Which of the following actions should the nurse take first?

Choice A rationale Initiating antibiotic therapy is a crucial intervention for bacterial meningitis to combat the infection and prevent complications. However, it's not the absolute first action. The immediate priority is to address the child's neurological status and reduce intracranial pressure, which is exacerbated by environmental stimuli. Antibiotics are administered shortly after obtaining blood cultures. Choice B rationale Minimizing environmental stimuli is the first priority to reduce the risk of seizures and decrease intracranial pressure. The inflammation of the meninges makes the brain more susceptible to overstimulation, which can trigger seizures. Reducing light, noise, and other stimuli creates a calm environment, which is vital for stabilizing the child's neurological status before other treatments are initiated. Choice C rationale Placing the child in a side-lying position is a helpful intervention to prevent aspiration and improve comfort. However, this is not the initial priority. The first action must address the immediate neurological risk posed by increased intracranial pressure and seizure potential, which is achieved by minimizing environmental stimuli. Choice D rationale Administering pain medication is important for the child’s comfort and to reduce the stress response. However, it is a secondary intervention. The primary action is to ensure the child's safety by mitigating neurological risks, which involves reducing environmental stimuli to prevent seizures and further increases in intracranial pressure.