The nurse is planning care for an infant diagnosed with bacterial meningitis. What would the nurse identify as a priority goal for this client’s care?

Choice A rationale Inspecting the lips and mouth for lesions, while part of a comprehensive assessment, is not the immediate priority goal for an infant with bacterial meningitis, as this infection primarily affects the central nervous system. The acute and life-threatening nature of increased intracranial pressure necessitates rapid intervention to prevent severe neurological damage or herniation. Choice B rationale Increased intracranial pressure (ICP) is a common and dangerous complication of bacterial meningitis due to cerebral edema and accumulation of exudate. Pain, often manifested as irritability or a high-pitched cry in infants, is a key sign of increased ICP, and reducing it is a priority to prevent further secondary brain injury and potential irreversible neurological sequelae. Choice C rationale Monitoring for hearing impairment is a critical ongoing intervention and long-term goal, as sensorineural hearing loss is a common complication of bacterial meningitis due to damage to the eighth cranial nerve or the cochlea. However, managing the acute, life-threatening symptoms like pain and increased ICP takes precedence over monitoring for a non-acute complication. Choice D rationale Fowler's position is generally used for older children or adults to help decrease ICP, but a flat or slight elevation is often safer for an infant to maintain a patent airway and prevent neck flexion. Extreme positions are avoided, and the primary focus must remain on managing the underlying pathophysiology like pain and reducing cerebral edema, which is more directly life-saving.