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 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:
- Ineffective Tissue Perfusion (Cerebral)
- Acute Pain
- Disturbed Sensory Perception
- Deficient Knowledge
- Risk for Injury
Risk for Injury
May be related to
- Internal factor of altered neurologic regulatory function.
Possibly evidenced by
- [not applicable]
- Child will not experience injury
|Assess neurologic status to include VS pattern, changes in consciousness, behavior patterns and pupillary/ocular responses appropriate for age (measure head circumference in infant) (specify when).||Provides information that offers clues to possible change in intracranial pressure caused by inflammation of the brain and associated edema.|
|Attach cardiac and respiratory monitor to assess for bradycardia and hypoxia.||Increased intracranial pressure will
decrease pulse and respirations, widen the pulse pressure with pulse becoming irregular and respirations rapid and shallow as ICP progresses and the body attempts to decrease blood flow to brain.
|Note any seizure activity including onset, frequency, duration and type of movements before, during, or after seizure; pad bed and remove objects/toys from bed and administer any ordered anticonvulsants.||Prevents injury during seizure which is a complication of meningitis.|
|Provide a quiet environment free from bright lighting, minimize gentle handling and care of infant/child, allow for rest periods between care or procedures, restrict visiting if irritable.||Promotes comfort and rest and reduces irritability.|
|Stay with infant/child and sit near
and speak in a low voice.
|Provides limited stimulation to infant/child during acute stage of disease.|
|Position with head elevated up to 30 degrees and maintain head alignment with sandbag.||Decreases intracranial pressure by allowing blood flow from brain by gravity or any obstruction of jugular drainage.|
|Reposition q 2h, positioning child to optimize comfort with HOB slightly elevated, no pillow in bed, side-lying position if nuchal rigidity present; avoid sudden movements such as lifting the head; have oxygen and suctioning equipment on hand to be administered when needed.||Maintains airway patency and prevents obstruction by secretion which increases CO2 retention and ICP.|
|Explain causes of increased ICP and
importance of preventing any further
increases in ICP.
|Allows for understanding of increased ICP and life-threatening nature of such a complication.|
|Inform parents of changes in condition, reasons for physical and mental changes and effects of the disease.||Promotes knowledge about possible manifestations of the disease and causes.|
|Inform of reason for seizure activity and other signs and symptoms of the disease and treatment necessitated by them.||Provides knowledge of seizure complications and actions and responsibility in prevention and/ or treatment of this activity.|
|Inform parents of risk for complications and need for monitoring for increased ICP; review signs and symptoms of increased ICP.||Allows for ongoing care and responsibility in preventing change in neurologic status.|
|Administer antibiotics as prescribed
(specify) as soon as ordered based on
analysis of CSF, throat cultures.
|Manages existing infection and prevents further spread of infection (action of drug).|
|Administer stool softeners, avoid use of restraints and prevent or reduce crying episodes.||Prevents Valsalva’s maneuver that will increase ICP.|
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Pediatric Nursing Care Plans
Nursing care plans for pediatric conditions and diseases:
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- Bronchiolitis | 5 Care Plans
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- 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