Which of the following are appropriate nursing interventions for a child with viral meningitis?

Choice A rationale Restricting fluids is generally contraindicated in meningitis unless there is documented syndrome of inappropriate antidiuretic hormone (SIADH) or severe, life-threatening cerebral edema. Maintaining adequate hydration is crucial to prevent dehydration and support systemic circulation, especially since fever can increase fluid loss. Choice B rationale Monitoring for signs of increased intracranial pressure (ICP) is paramount because meningeal inflammation can lead to cerebral edema and impaired CSF reabsorption. Signs like changes in level of consciousness, bradycardia, and hypertension (Cushing's triad) require immediate intervention to prevent brain herniation. Choice C rationale Administering acetaminophen (or ibuprofen) is appropriate for controlling the systemic symptoms of fever (pyrexia) and managing headache/body pain associated with meningeal irritation. Effective fever control reduces metabolic demands and can decrease the risk of febrile seizures. Choice D rationale Administering IV antibiotics immediately is the standard for bacterial meningitis to prevent morbidity and mortality, but viral meningitis is typically self-limiting and managed with supportive care; thus, empirical antibiotics are not indicated if the viral etiology is confirmed or highly suspected. Choice E rationale Encouraging rest and hydration is the cornerstone of supportive care for viral meningitis. Rest reduces cerebral metabolic demand and prevents overexertion, while hydration helps combat fluid losses from fever and vomiting and supports overall recovery. Choice F rationale Providing a quiet, dimly lit environment helps reduce noxious stimuli that can exacerbate common symptoms like headache and photophobia (light sensitivity), which are caused by meningeal inflammation and irritation of cranial nerves, thus promoting comfort and rest.