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.
- Ineffective Tissue Perfusion (Cerebral)
- Acute Pain
- Disturbed Sensory Perception
- Deficient Knowledge
- Risk for Injury
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.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans related to neurological disorders:
- Alzheimer’s Disease | 15 Care Plans
- Brain Tumor | 3 Care Plans
- Cerebral Palsy | 7 Care Plans
- Cerebrovascular Accident | 12 Care Plans
- Guillain-Barre Syndrome | 6 Care Plans
- Meningitis | 7 Care Plans
- Multiple Sclerosis | 9 Care Plans
- Parkinson’s Disease | 9 Care Plans
- Seizure Disorder | 4 Care Plans
- Spinal Cord Injury | 12 Care Plans