Meningitis is the inflammation of the meninges of the brain and spinal cord as a result of either bacteria, viral or fungal infection. Bacterial infections may be caused by Haemophilus influenzae type b, Neisseria meningitidis (meningococcal meningitis), and Streptococcus pneumoniae (pneumococcal meningitis). Those at greatest risk for this disease are infants between 6 and 12 months of age with most cases occurring between 1 month and 5 years of age. The most common route of infection is vascular dissemination from an infection in the nasopharynx or sinuses, or one implanted as a result of wounds, skull fracture, lumbar puncture, or surgical procedure. Viral (aseptic) meningitis is caused by a variety of viral agents and usually associated with measles, mumps, herpes, or enteritis. This form of meningitis is self-limiting and treated symptomatically for 3 to 10 days.
Treatment includes hospitalization to differentiate between the two types of meningitis, isolation and management of symptoms, and prevention of complications.
Nursing Care Plans
Nursing care plan goals for a child with meningitis include attain adequate cerebral tissue perfusion through reduction in ICP, maintain normal body temperature, protection against injury, enhance coping measures, accurate perception of environmental stimuli, restoring normal cognitive functions and prevention of complications.
Here are seven (7) nursing care plans (NCP) for meningitis:
- Ineffective Tissue Perfusion (Cerebral)
- Hyperthermia
- Acute Pain
- Disturbed Sensory Perception
- Anxiety
- Deficient Knowledge
- Risk for Injury
Ineffective Tissue Perfusion (Cerebral)
Ineffective Tissue Perfusion: Decreased in the oxygen resulting in the failure to nourish the tissues at the capillary level
May be related to
- Increased intracranial pressure
- Cerebral edema
Possibly evidenced by
- Delirium, hallucinations
- Drowsiness
- Hypercapnia
Desired Outcomes
- Child will have vital signs return to normal; child is alerted and oriented: motor, cognitive, and sensory function are within acceptable parameters for the child’s age; normal specific urine gravity.
| Nursing Interventions | Rationale |
|---|---|
| Monitor vital signs and neurological status. | Increasing systolic blood pressure accompanied by decreasing diastolic blood pressure is an ominous sign of increased ICP. |
| Observe for any signs of increased intracranial pressure. | Signs and symptoms that indicate an increase in ICP include headache, drowsiness, decreased alertness, vomiting, bulging fontanelle (infants). |
| Assess for nuchal rigidity, twitching, increased restlessness, and irritability. | These are signs of meningeal irritation, which may happen because of infection. |
| Observe for increasing restlessness, moaning, and guarding behaviors. | These nonverbal cues may indicate increasing ICP or pain. Unrelieved pain can potentiate increased ICP. |
| Monitor arterial blood gases (ABGs) and oxygen saturation. | Determines presence of hypoxia and indicates therapy needs. |
| Maintain head or neck in midline position, provide small pillow for support. | Turning head to one side compresses the jugular veins and inhibits venous drainage, thereby increasing ICP. |
| During reposition, avoid bending of the knee and pushing heels against the mattress. | These activities increase intra-thoracic and intrabdominal pressures, thereby increasing ICP. |
| Provide comfort measures and Decrease external stimuli such as quiet environment, soft voice, and gentle touch. | Produces relaxing effect which decreases adverse physiologic response and promotes rest to maintain or lower ICP. |
| Elevate the head of the bed 30°, and avoid neck flexion and hip flexion. | Promotes venous drainage from head, thereby reducing cerebral congestion and edema and risk of increased ICP. |
| Administer oxygen as needed. | Reduces hypoxia which can increase blood volume, promotes cerebral vasodilation and elevate ICP. |
| Administer medications as indicated: | |
| Used to treat cerebral edema by promoting cerebral blood flow | |
|
Used to control seizures related to increased intracranial pressure. |
See Also
You may also like the following posts and care plans:
Pediatric Nursing Care Plans
Nursing care plans for pediatric conditions and diseases:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Rheumatic Fever | 4 Care Plans
- Apnea | 4 Care Plans
- Bronchiolitis | 5 Care Plans
- Bronchopulmonary Dysplasia | 5 Care Plans
- Cardiac Catheterization (Pediatric) | 4 Care Plans
- Cerebral Palsy | 7 Care Plans
- Child Abuse | 4 Care Plans
- Cleft Lip and Cleft Palate | 6 Care Plans
- Congenital Heart Disease | 5 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Croup Syndrome | 5 Care Plans
- Cryptorchidism (Undescended Testes) | 3 Care Plans
- Cystic Fibrosis | 5 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Dying Child | 4 Care Plans
- Epiglottitis | 5 Care Plans
- Febrile Seizure | 4 Care Plans
- Guillain-Barre Syndrome | 6 Care Plans
- Hospitalized Child | 5 Care Plans
- Hydrocephalus | 5 Care Plans
- Hypospadias and Epispadias | 4 Care Plans
- Intussusception | 3 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Kawasaki Disease | 6 Care Plans
- Meningitis | 7 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Osteogenic Sarcoma (Osteosarcoma) | 4 Care Plans
- Otitis Media | 4 Care Plans
- Scoliosis | 4 Care Plans
- Spina Bifida | 7 Care Plans
- Tonsillitis and Adenoiditis | 4 Care Plans
- Umbilical and Inguinal Hernia | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans
- Wilms Tumor (Nephroblastoma) | 4 Care Plans
Further Reading
Recommended books and resources:
- Nursing Care Plans: Diagnoses, Interventions, and Outcomes
- Nurse's Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
- Nursing Diagnoses 2015-17: Definitions and Classification
- Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR)
- Manual of Psychiatric Nursing Care Planning
- Maternal Newborn Nursing Care Plans
- Delmar's Maternal-Infant Nursing Care Plans, 2nd Edition
- Maternal Newborn Nursing Care Plans
