Meningitis Nursing Care Plan & Management

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Notes

Description

Meningitis is inflammation of the arachnoid and pia mater of the brain and spinal cord.
Meningitis is caused by bacterial and viral organisms, although fungal and protozoal meningitis also occurs.
Cerebrospinal fluid is analyzed to determine the diagnosis and the type of meningitis.

Transmission

Transmission is by direct contact, including droplet spread.
Transmission occurs in areas of high population density, crowded living areas, and prisons.

Causes

Meningitis is most frequently caused by bacterial or viral agents.
In newborns, Streptococcus pneumoniae is the most frequent bacterial organism; in other age groups, it is S. pneumonia and Neisseria meningitidis. Haemophilus influenzae is the most common organism in unvaccinated children and adults who contract meningitis.
Viral meningitis is caused by many viruses. Depending on the cause, isolation precautions may be indicated early in treatment. There has been a decrease in viral meningitis in locations where immunizations have become routine.

Predisposing Factors

Skull fractures
Brain or spinal surgery
Sinus or upper respiratory infections
Use of nasal sprays
Individuals with a compromised immune system

Assessment

Mild lethargy
Memory changes
Short attention span
Personality and behavior changes
Severe headache
Generalized muscle aches and [pains
Nausea and vomiting
Fever and chills
Tachycardia
Deterioration in the level of consciousness
Photophobia
Signs of meningeal irritation such as nuchial rigidity and positive Kernig’s sign and Brudzinski’s sign
Red, macular rash with meningococcal meningitis
Abdominal and chest pain with viral meningitis

Brudzinski’s sign. Severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed.

Kernig’s sign. Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees.

Possible Complications

Brain damage
Hearing loss or deafness
Hydrocephalus
Loss of vision

Primary Nursing Diagnosis

Infection related to pathogens in the CSF

Diagnostic Evaluation

Lumbar puncture for cerebrospinal fluid (CSF) analysis reveals positive cultures with invading microorganism; sensitivities identify antibiotics that will kill bacteria; cells: 200/μL; protein: elevated >50 mg/dL (viral) and >500 mg/dL (bacterial); glucose: <45 mg/dL; color: may be cloudy or hazy; pressure: elevated; gram stain: bacteria stain either gram positive (blue) or gram negative (red). Lumbar puncture for cerebrospinal fluid (CSF) analysis identifies invading microorganisms. Increased protein occurs as the result of the presence of viruses or bacteria; glucose is decreased as microorganisms use glucose for metabolism. Lumbar puncture is not done in the presence of known increased intracranial pressure.
Other Tests: Brain scan, computed tomography (CT) scan, magnetic resonance imaging (MRI), cultures and sensitivities (blood, nasal swab, urine), C-reactive protein, complete blood count, counter -immunoelectrophoresis (to determine presence of viruses or protozoa in CSF), chest x-ray

A lumbar puncture, or spinal tap, is a procedure to collect cerebrospinal fluid to check for the presence of disease or injury. A spinal needle is inserted, usually between the 3rd and 4th lumbar vertebrae in the lower spine. Once the needle is properly positioned in the subarachnoid space (the space between the spinal cord and its covering, the meninges), pressures can be measured and fluid can be collected for testing.

Medical Management

The most critical treatment is the rapid initiation of antibiotic therapy. In addition, assessment and maintenance of airway, breathing, and circulation (ABCs) are essential. Treatment with intubation, mechanical ventilation, and hyperventilation may occur if the patient’s airway and breathing are threatened. Serial neurological assessments and vital signs not only monitor critical changes in the patient but also monitor the patient’s response to therapy. Supportive measures such as bedrest and temperature control with antipyretics or hypothermia limit oxygen consumption. Gradual treatment of hyperthermia is required to prevent shivering.
Other strategies to manage increased ICP include osmotic diuretics, such as mannitol, or intraventricular CSF drainage and ICP pressure monitoring. Fluids are often restricted if signs of cerebral edema or excessive secretion of antidiuretic hormone are present. If the patient experiences seizures, the physician prescribes anticonvulsant medications. Surgical interventions or CSF drainage may be required to prevent permanent neurological deficits as a result of complications such as hydrocephalus or abscesses. The patient is likely to have a severe headache from increased ICP. Because large doses of narcotic analgesia mask important neurological changes, most physicians prescribe a mild analgesic to decrease discomfort. In children, pain relief decreases crying and fretting, which if left untreated, have the potential to aggravate increased ICP.
Rehabilitation begins with the acute phase of the illness but becomes increasingly important as the infection subsides. If residual neurological dysfunction is present as a result of irritation, pressure, or brain and nerve damage, an individualized rehabilitation program with a multidisciplinary team is required. Vision and auditory testing should be done at discharge and at intervals during long-term recovery because early interventions for these deficits are needed to prevent developmental delays.

Pharmacologic Highlights

Antimicrobial therapy: penicillin (or piperacillin or ampicillin), or one of the cephalosporins. The treatment for cryptococcal meningitis is intravenous administration of amphotericin B; may be used with or without 5-flucytosine.
Vancomycin hydrochloride, alone or in combination with rifampin, may be used if resistant strains of bacteria are identified.
Dexamethasone may be beneficial as adjunct therapy for acute bacterial meningitis and pneumococcal meningitis.
Fluid volume expanders are used to treat dehydration and shock.
Diazepam (Valium) or phenytoin (Dilantin) is used to control seizures.
An osmotic diuretic, such as mannitol, is used to treat cerebral edema.

Nursing Interventions

Monitor vital signs and neurological signs.
Assess for signs of increasing ICP.
Initiate seizure precautions.
Monitor for seizure activity.
Monitor for signs of meningeal irritation.
Perform cranial nerve assessment.
Assess peripheral vascular status.
Maintain isolation precautions as necessary with bacterial meningitis.
Maintain urine and stool precautions with viral meningitis.
Maintain respiratory isolation for the client with pneumococcal meningitis.
Elevate the head of the bed 30 degrees, and avoid neck flexion and extreme hip flexion.
Prevent stimulation and restrict visitors.
Administer analgesics as prescribed.
Administer antibiotics as prescribed.

Documentation Guidelines

Physiological response: Neurological examination; vital signs; presence of fever; adequacy of airway, breathing, and circulation
Fluid and electrolyte balance: Intake and output, body weight, skin turgor, abnormal serum electrolytes
Complications: Seizure activity, decreased mental status, fever, increased ICP

Discharge and Home Healthcare Guidelines

Explain all medications and include the mechanism of action, dosage, route, and side effects.
Explain any drug interactions or food interactions.
Instruct the patient to notify the primary healthcare provider for signs and symptoms of complications, such as fever, seizures, developmental delays, or behavior changes.
Provide referrals and teaching specific to the identified neurological deficits.
Encourage the parents to maintain appropriate activities to facilitate the growth and development of the child.

Exam

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Question 1

A client is admitted and has been diagnosed with bacterial (meningococcal) meningitis. The infection control registered nurse visits the staff nurse caring to the client. What statement made by the nurse reflects an understanding of the management of this client?

A	speech pattern may be altered
B	Respiratory isolation is necessary for 24 hours after antibiotics are started
C	Perform skin culture on the macular popular rash
D	Expect abnormal general muscle contractions

Question 1 Explanation:

After a minimum of 24 hours of IV antibiotics, the client is no longer considered communicable. Evaluation of the nurse’s knowledge is needed for safe care and continuity of care.

Question 2

Among children aged 2 months to 3 years, the most prevalent form of meningitis is caused by which microorganism?

A	Steptococcus pneumoniae
B	Hemophilus influenzae
C	Neisseria meningitidis
D	Morbillivirus

Question 2 Explanation:

Hemophilus meningitis is unusual over the age of 5 years. In developing countries, the peak incidence is in children less than 6 months of age. Morbillivirus is the etiology of measles. Streptococcus pneumoniae and Neisseria meningitidis may cause meningitis, but age distribution is not specific in young children.

Question 3

You have just admitted a patient with bacterial meningitis to the medical-surgical unit. The patient complains of a severe headache with photophobia and has a temperature of 102.60 F orally. Which collaborative intervention must be accomplished first?

A	Give furosemide (Lasix) 40 mg IV to decrease intracranial pressure.
B	Give acetaminophen (Tylenol) 650 mg orally to reduce the fever.
C	Infuse ceftriaxone (Rocephin) 2000 mg IV to treat the infection.
D	Administer codeine 15 mg orally for the patient’s headache.

Question 3 Explanation:

Untreated bacterial meningitis has a mortality are approaching 100%, so rapid antibiotic treatment is essential. The other interventions will help reduce CNS stimulation and irritation, and should be implemented as soon as possible. Focus: Prioritization

Question 4

The nurse is assessing a child diagnosed with a brain tumor. Which of the following signs and symptoms would the nurse expect the child to demonstrate? Select all that apply.

A	Increased appetite
B	Increased pulse
C	Polydipsia
D	Lethargy
E	Vomiting
F	Head tilt

Question 4 Explanation:

Head tilt, vomiting, and lethargy are classic signs assessed in a child with a brain tumor. Clinical manifestations are the result of location and size of the tumor.

Question 5

A client, age 22, is admitted with bacterial meningitis. Which hospital room would be the best choice for this client?

A	A two-bed room with a client who previously had bacterial meningitis
B	A private room down the hall from the nurses’ station
C	An isolation room three doors from the nurses’ station
D	A semiprivate room with a 32-year-old client who has viral meningitis

Question 5 Explanation:

A client with bacterial meningitis should be kept in isolation for at least 24 hours after admission and, during the initial acute phase, should be as close to the nurses’ station as possible to allow maximal observation. Placing the client in a room with a client who has viral meningitis may cause harm to both clients because the organisms causing viral and bacterial meningitis differ; either client may contract the other’s disease. Immunity to bacterial meningitis can’t be acquired; therefore, a client who previously had bacterial meningitis shouldn’t be put at risk by rooming with a client who has just been diagnosed with this disease.

Question 6

A child is admitted to the pediatric unit with a diagnosis of suspected meningococcal meningitis. Which of the following nursing measures should the nurse do FIRST?

A	Assess vital signs
B	Institute seizure precautions
C	Place in respiratory isolation
D	Assess neurologic status

Question 6 Explanation:

The initial therapeutic management of acute bacterial meningitis includes isolation precautions, initiation of antimicrobial therapy and maintenance of optimum hydration. Nurses should take necessary precautions to protect themselves and others from possible infection.

Question 7

The mother brings a child to the health care clinic because of severe headache and vomiting. During the assessment of the health care nurse, the temperature of the child is 40 degree Celsius, and the nurse notes the presence of nuchal rigidity. The nurse is suspecting that the child might be suffering from bacterial meningitis. The nurse continues to assess the child for the presence of Kernig’s sign. Which finding would indicate the presence of this sign?

A	Calf pain when the foot is dorsiflexed
B	Pain when the chin is pulled down to the chest
C	Inability of the child to extend the legs fully when lying supine
D	Flexion of the hips when the neck is flexed from a lying position

Question 7 Explanation:

Kernig’s sign is the inability of the child to extend the legs fully when lying supine. This sign is frequently present in bacterial meningitis. Nuchal rigidity is also present in bacterial meningitis and occurs when pain prevents the child from touching the chin to the chest.

Question 8

A nurse is putting together a presentation on meningitis. Which of the following microorganisms has not been linked to meningitis in humans?

A	H. influenza
B	S. pneumonia
C	N. meningitis
D	Cl. difficile

Question 8 Explanation:

Cl. difficile has not been linked to meningitis.

Question 9

A patient’s chart indicates a history of meningitis. Which of the following would you not expect to see with this patient if this condition were acute?

A	Vomiting
B	Increased appetite
C	Fever
D	Poor tolerance of light

Question 9 Explanation:

Loss of appetite would be expected.

Question 10

Patrick, a healthy adolescent has meningitis and is receiving I.V. and oral fluids. The nurse should monitor this client’s fluid intake because fluid overload may cause:

A	Dehydration
B	Heart failure
C	Cerebral edema
D	Hypovolemic shock

Question 10 Explanation:

Because of the inflammation of the meninges, the client is vulnerable to developing cerebral edema and increase intracranial pressure. Fluid overload won’t cause dehydration. It would be unusual for an adolescent to develop heart failure unless the overhydration is extreme. Hypovolemic shock would occur with an extreme loss of fluid of blood.

Question 11

Meningitis occurs as an extension of a variety of bacterial infections due to which of the following conditions?

A	Congenital anatomic abnormality of the meninges
B	Lack of acquired resistance to the various etiologic organisms
C	Occlusion or narrowing of the CSF pathway
D	Natural affinity of the CNS to certain pathogens

Question 11 Explanation:

Extension of a variety of bacterial infections is a major causative factor of meningitis and occurs as a result of a lack of acquired resistance to the etiologic organisms. Preexisting CNS anomalies are factors that contribute to susceptibility.

Question 12

Richard Barnes was diagnosed with pneumococcal meningitis. What response by the patient indicates that he understands the precautions necessary with this diagnosis?

A	“The doctor is a good friend of mine and won’t keep me in isolation.”
B	“The nurse told me that my urine and stool are also sources of meningitis bacteria.”
C	“I’m so depressed because I can’t have any visitors for a week.”
D	“Thank goodness, I’ll only be in isolation for 24 hours.”

Question 12 Explanation:

Patient with pneumococcal meningitis require respiratory isolation for the first 24 hours after treatment is initiated.

Question 13

When interviewing the parents of a 2-year-old child, a history of which of the following illnesses would lead the nurse to suspect pneumococcal meningitis?

A	Bladder infection
B	Fractured clavicle
C	Septic arthritis
D	Middle ear infection

Question 13 Explanation:

Organisms that cause bacterial meningitis, such as pneumococci or meningococci, are commonly spread in the body by vascular dissemination from a middle ear infection. The meningitis may also be a direct extension from the paranasal and mastoid sinuses. The causative organism is a pneumonococcus. A chronically draining ear is frequently also found.

Question 14

The nurse is evaluating the status of a client who had a craniotomy 3 days ago. The nurse would suspect the client is developing meningitis as a complication of surgery if the client exhibits:

A	Absence of nuchal rigidity
B	A negative Kernig’s sign
C	A Glascow Coma Scale score of 15
D	A positive Brudzinski’s sign

Question 14 Explanation:

Signs of meningeal irritation compatible with meningitis include nuchal rigidity, positive Brudzinski’s sign, and positive Kernig’s sign. Nuchal rigidity is characterized by a stiff neck and soreness, which is especially noticeable when the neck is fixed. Kernig’s sign is positive when the client feels pain and spasm of the hamstring muscles when the knee and thigh are extended from a flexed-right angle position. Brudzinski’s sign is positive when the client flexes the hips and knees in response to the nurse gently flexing the head and neck onto the chest. A Glascow Coma Scale of 15 is a perfect score and indicates the client is awake and alert with no neurological deficits.

Question 15

Which of the following assessment data indicated nuchal rigidity?

A	Negative Brudzinski’s sign
B	Positive Kernig’s sign
C	Negative Kernig’s sign
D	Positive homan’s sign

Question 15 Explanation:

A positive Kernig’s sign indicated nuchal rigidity, caused by an irritative lesion of the subarachnoid space. Brudzinski’s sign is also indicative of the condition.

Question 16

A client is admitted with a diagnosis of meningitis caused by Neisseria meningitides. The nurse should institute which type of isolation precautions?

A	Droplet precautions
B	Standard precautions
C	Contact precautions
D	Airborne precautions

Question 16 Explanation:

This client requires droplet precautions because the organism can be transmitted through airborne droplets when the client coughs, sneezes, or doesn’t cover his mouth. Airborne precautions would be instituted for a client infected with tuberculosis. Standard precautions would be instituted for a client when contact with body substances is likely. Contact precautions would be instituted for a client infected with an organism that is transmitted through skin-to-skin contact.

Question 17

A nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which of the following would be included in the plan of care?

A	Maintain neutropenic precautions
B	Maintain enteric precautions
C	Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics
D	No precautions are required as long as antibiotics have been started

Question 17 Explanation:

A major priority of nursing care for a child suspected of having meningitis is to administer the prescribed antibiotic as soon as it is ordered. The child is also placed on respiratory isolation for at least 24 hours while culture results are obtained and the antibiotic is having an effect.

Question 18

Which of the following pathologic processes is often associated with aseptic meningitis?

A	Ischemic infarction of cerebral tissue
B	Cerebral ventricular irritation from a traumatic brain injury
C	Childhood diseases of viral causation such as mumps
D	Brain abscesses caused by a variety of pyogenic organisms

Question 18 Explanation:

Aseptic meningitis is caused principally by viruses and is often associated with other diseases such as measles, mumps, herpes, and leukemia. Incidences of brain abscess are high in bacterial meningitis, and ischemic infarction of cerebral tissue can occur with tubercular meningitis. Traumatic brain injury could lead to bacterial (not viral) meningitis.

Question 19

The adolescent patient has symptoms of meningitis: nuchal rigidity, fever, vomiting, and lethargy. The nurse knows to prepare for the following test:

A	throat and ear culture.
B	blood culture.
C	CAT scan.
D	lumbar puncture.

Question 19 Explanation:

Meningitis is an infection of the meninges, the outer membrane of the brain. Since it is surrounded by cerebrospinal fluid, a lumbar puncture will help to identify the organism involved.

Question 20

A nurse is reviewing the record of a child with increased ICP and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse would expect to note which of the following if this type of posturing was present?

A	Rigid extension and pronation of the arms and legs
B	Rigid pronation of all extremities
C	Abnormal flexion of the upper extremities and extension of the lower extremities
D	Flaccid paralysis of all extremities

Question 20 Explanation:

Decebrate posturing is characterized by the rigid extension and pronation of the arms and legs.

Question 21

A lumbar puncture is performed on a child suspected of having bacterial meningitis. CSF is obtained for analysis. A nurse reviews the results of the CSF analysis and determines that which of the following results would verify the diagnosis?

A	Cloudy CSF, decreased protein, and decreased glucose
B	Clear CSF, decreased pressure, and elevated protein
C	Cloudy CSF, elevated protein, and decreased glucose
D	Clear CSF, elevated protein, and decreased glucose

Question 21 Explanation:

A diagnosis of meningitis is made by testing CSF obtained by lumbar puncture. In the case of bacterial meningitis, findings usually include an elevated pressure, turbid or cloudy CSF, elevated leukocytes, elevated protein, and decreased glucose levels.

Question 22

You are mentoring a student nurse in the intensive care unit (ICU) while caring for a patient with meningococcal meningitis. Which action by the student requires that you intervene immediately?

A	The student instructs the family that visits are restricted to 10 minutes.
B	The student gives the patient a warm blanket when he says he feels cold.
C	The student enters the room without putting on a mask and gown.
D	The student checks the patient’s pupil response to light every 30 minutes.

Question 22 Explanation:

Meningococcal meningitis is spread through contact with respiratory secretions so use of a mask and gown is required to prevent spread of the infection to staff members or other patients. The other actions may not be appropriate but they do not require intervention as rapidly. The presence of a family member at the bedside may decrease patient confusion and agitation. Patients with hyperthermia frequently complain of feeling chilled, but warming the patient is not an appropriate intervention. Checking the pupil response to light is appropriate, but it is not needed every 30 minutes and is uncomfortable for a patient with photophobia. Focus: Prioritization

Question 23

Which of the following would lead the nurse to suspect that a child with meningitis has developed disseminated intravascular coagulation?

A	Cyanosis
B	Dyspnea on exertion
C	Hemorrhagic skin rash
D	Edema

Question 23 Explanation:

DIC is characterized by skin petechiae and a purpuric skin rash caused by spontaneous bleeding into the tissues. An abnormal coagulation phenomenon causes the condition.

Question 24

A client is arousing from a coma and keeps saying, “Just stop the pain.” The nurse responds based on the knowledge that the human body typically and automatically responds to pain first with attempts to:

A	Tolerate the pain
B	Divert attention from the source of pain
C	Escape the source of pain
D	Decrease the perception of pain

Question 24 Explanation:

The client’s innate responses to pain are directed initially toward escaping from the source of pain. Variations in individuals’ tolerance and perception of pain are apparent only in conscious clients, and only conscious clients are able to employ distraction to help relieve pain.

Question 25

A 5-month-old infant is admitted to the ER with a temperature of 6°F and irritability. The mother states that the child has been listless for the past several hours and that he had a seizure on the way to the hospital. A lumbar puncture confirms a diagnosis of bacterial meningitis. The nurse should assess the infant for:

A	Periorbital edema
B	Positive Babinski reflex
C	Tenseness of the anterior fontanel
D	Negative scarf sign

Question 25 Explanation:

Tenseness of the anterior fontanel indicates an increase in intracranial pressure. Periorbital edema is incorrect because periorbital edema is not associated with meningitis. Positive Babinski reflex is incorrect because a positive Babinski reflex is normal in the infant. Negative scarf sign is incorrect because it relates to the preterm infant, not the infant with meningitis.

Question 26

Dexamethasone improves mortality in meningococcal meningitis

A	False
B	True

Question 27

The nurse is assessing a patient and notes a Brudzinski’s sign and Kernig’s sign. These are two classic signs of which of the following disorders?

A	Seizure disorder
B	Cerebrovascular accident (CVA)
C	Parkinson’s disease
D	Meningitis

Question 27 Explanation:

A positive response to one or both tests indicates meningeal irritation that is present with meningitis. Brudzinski’s and Kernig’s signs don’t occur in CVA, seizure disorder, or Parkinson’s disease.

Question 28

The client with suspected meningitis is admitted to the unit. The doctor is performing an assessment to determine meningeal irritation and spinal nerve root inflammation. A positive Kernig’s sign is charted if the nurse notes:

A	Dizziness when changing positions
B	Nuchal rigidity on flexion of the neck
C	Pain on flexion of the hip and knee
D	Pain when the head is turned to the left side

Question 28 Explanation:

Kernig’s sign is positive if pain occurs on flexion of the hip and knee. The Brudzinski reflex is positive if pain occurs on flexion of the head and neck onto the chest.

Question 29

During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which of the following would be most appropriate to institute?

A	Allowing the child to play in the bathtub
B	Limiting conversation with the child
C	Keeping extraneous noise to a minimum
D	Performing treatments quickly

Question 29 Explanation:

A child in the acute stage of meningitis is irritable and hypersensitive to loud noise and light. Therefore, extraneous noise should be minimized and bright lights avoided as much as possible. There is no need to limit conversations with the child. However, the nurse should speak in a calm, gentle, reassuring voice. The child needs gentle and calm bathing. Because of the acuteness of the infection, sponge baths would be more appropriate than tub baths. Although treatments need to be completed as quickly as possible to prevent overstressing the child, any treatments should be performed carefully and at a pace that avoids sudden movements to prevent startling the child and subsequently increasing intracranial pressure.

Question 30

A 4-month-old with meningococcal meningitis has just been admitted to the pediatric unit. Which nursing intervention has the highest priority?

A	Instituting droplet precautions
B	Orienting the parents to the pediatric unit
C	Administering acetaminophen (Tylenol)
D	Obtaining history information from the parents

Question 30 Explanation:

Instituting droplet precautions is a priority for a newly admitted infant with meningococcal meningitis. Acetaminophen may be prescribed but administering it doesn’t take priority over instituting droplet precautions. Obtaining history information and orienting the parents to the unit don’t take priority.

Question 31

Which of these patients in the neurologic ICU will be best to assign to an RN who has floated from the medical unit?

A	A 42-year-old patient admitted several hours ago with a headache and diagnosed with a ruptured berry aneurysm.
B	A 26-year-old patient with a basilar skull structure who has clear drainage coming out of the nose
C	A 65-year-old patient with a astrocytoma who has just returned to the unit after having a craniotomy
D	A 46-year-old patient who was admitted 48 hours ago with bacterial meningitis and has an antibiotic dose due

Question 31 Explanation:

This patient is the most stable of the patients listed. An RN from the medical unit would be familiar with administration of IV antibiotics. The other patients require assessments and care from RNs more experienced in caring for patients with neurologic diagnoses. Focus: Assignment.

Question 32

A 4 year old girl is admitted with pneumococcal meningitis. She has just returned from a holiday to Disneyland, Florida, 2 days before. What are you going to treat her with:

A	benzylpenicillin and rifampicin
B	cefotaxime and vancomycin
C	amoxicillin and gentamicin
D	ceftriaxone

Question 32 Explanation:

The USA has a high rate of penicillin resistant pneumococi and first line treatment should include vancomycin until sensitivities are known.

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Nursing Care Plan

Sample Nursing Care Plan for Meningitis

Nursing Diagnosis

Acute pain

Related to

infection process
toxin in the circulation

Nursing Intervention for Meningitis:

Place the ice bag on his head, cool clothing above the eyes, provide a comfortable head position a little bit high, range of motion exercises and active or passive masage neck muscles.
Support to find a comfortable position (head rather high-).
Give range of motion exercises active / passive.
Use a warm moisturizer, neck or hip.

Nursing Diagnosis

Impaired Physical Mobility

Related to

neuromuscular damage.

Nursing Intervention for Meningitis:

Assess the degree of immobilization of the patient.
Assistive range of motion exercises.
Give skin care, massage with moisturizer.
Check the area experiencing tenderness, give air mattresses or water body alignment are functionally notice.
Provide training programs and the use of mobilization.

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Notes

Description

Transmission

Causes

Predisposing Factors

Assessment

Possible Complications

Primary Nursing Diagnosis

Diagnostic Evaluation

Medical Management

Pharmacologic Highlights

Nursing Interventions

Documentation Guidelines

Discharge and Home Healthcare Guidelines

Exam

MSN Exam for Meningitis (PM)

Nursing Care Plan

Nursing Diagnosis

Related to

Nursing Intervention for Meningitis:

Nursing Diagnosis

Related to

Nursing Intervention for Meningitis:

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