7 Meningitis Nursing Care Plans

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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) and nursing diagnosis (NDx) for meningitis:

  1. Ineffective Tissue Perfusion (Cerebral)
  2. Hyperthermia
  3. Acute Pain
  4. Disturbed Sensory Perception
  5. Anxiety
  6. Deficient Knowledge
  7. Risk for Injury
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Disturbed Sensory Perception

Disturbed Sensory Perception: Change in the amount or patterning of incoming stimuli accompanied by a diminished, exaggerated, distorted, or impaired response to such stimuli

May be related to

Possibly evidenced by

  • Altered sensorium

Desired Outcomes

  • Child will maintain normal LOC.
Nursing InterventionsRationale
Assess level of consciousness using pediatric Glasgow coma scale.Glasgow coma scale is a reliable and objective way of measuring the motor, verbal and sensory cues related to LOC. Neurological assessment aids in determining the extent of damage in meningitis.
Observe and notify physician for persistent deterioration in LOC.Additional or changes in the treatment may be required once the LOC furtherly decreases. Change in mentation, seizures, increased blood pressure (BP), bradycardia, or respiratory abnormalities may indicate increasing ICP with decreased cerebral perfusion pressure.
Assess for signs of cerebral edema such as dizziness, headache, irregular breathing, neck pain, nausea or vomiting.Anoxia, vasodilation, or vascular stasis can lead to cerebral edema due to the increased intracellular and extracellular fluid in the brain as the symptoms progress.
Assess ability to follow simple or complex commands.Impaired cognitive function occurs with cerebral hemisphere involvement.
Evaluate presence or absence of protective reflexes: swallow, gag, blink, cough.Absence of reflexes is a late sign indicative of increasing ICP.
Assess for signs of meningeal irritation such as headache, photobia, nuchal rigidity, opisthotonic position, Kernig’s sign, Brudzinki’s sign.Meningeal signs are a result of meningeal and spinal root inflammation, and/or pooling of infectious exudates and are cardinal features of meningeal irritation.
Elevate head of bed up to 30° to 45° with the client’s head in neutral position.Promotes venous outflow from the brain and help decrease ICP.
Reorient the client to the environment, as needed.Frequent reality orientation is important to promote cognitive function.
Assist with diagnostic testing:

  • Electroencephalogram
  • Lumbar puncture for CSF
  • Magnetic resonance imaging (MRI), computed tomography (CT), or ventriculogram
The following diagnostic exam are done to evaluate cerebral pressure and identify the presence of infectious organisms.
Initiate seizure precautions: observe and provide care during seizure.Providing appropriate and precise care during a seizure prevents complication and further brain damage.
Maintain a quiet environment and keep the lights dim.Prevents stimulation that can cause or precipitate an episode of convulsion.
Assess pupil size every 3 hours during the first 24 hours and consequently every 6 hours.Increased intracranial pressure (ICP) will result in uneven pupil sizes, fixed dilated pupil.
Observe and document pattern and frequency of seizure. Notify physician of seizure activity.Changes in seizure pattern signify the need for additional neurological evaluation, anticonvulsant medications, and reevaluation of treatment. Seizure usually happens prior an increase in intracranial pressure (ICP). Adequate treatment of infection will mitigate further deterioration and maintain intracranial pressure within normal limits.
Allow parents to participate in the child’s care.Support better coping and decrease anxiety.
Administer and monitor anticonvulsants drug levels.Anticonvlsants are both used as prophylaxis and treatment. Therapy involves keeping therapeutic blood levels to avoid the occurrence of seizures.
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See Also

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