7 Meningitis Nursing Care Plan

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Make Nursing Interventions and Nursing Diagnostic by using this Meningitis Nursing Care Plan guidance.

Inflammation of the meninges around the brain and spinal cord caused by a bacterial, viral, or fungal infection is known as meningitis. Haemophilus influenzae type b, Neisseria meningitidis (meningococcal meningitis), and Streptococcus pneumoniae are three bacteria that can cause bacterial illnesses (pneumococcal meningitis). Infants between the ages of 6 and 12 months are most at risk for this condition, and most instances happen in patients between the ages of 1 month and 5 years. Vascular dispersion from an infection in the sinuses or nasopharynx, or one implanted as a result of wounds, skull fractures, lumbar punctures, or surgical procedures, is the most typical route of infection. Viruses can cause viral (aseptic) meningitis, which is frequently linked to the measles, mumps, herpes, or enteritis. Treatment for this kind of meningitis is symptomatic for 3 to 10 days until it self-limits.

Hospitalization is used to distinguish between the two kinds of meningitis, followed by isolation, symptom treatment, and the avoidance of sequelae.

Meningitis Nursing Care Plan

Meningitis Nursing Care Plan

The nursing care aims for a child with meningitis include maintaining normal body temperature, preventing damage, improving coping mechanisms, accurately perceiving environmental cues, regaining normal cognitive skills, and avoiding complications.

Meningitis Nursing Care Plan

1. Ineffective Tissue Perfusion (Cerebral)

Nursing Diagnosis

Ineffective Tissue Perfusion (Cerebral)

May be related to

  • The pressure inside the skull has risen
  • Cerebral edema

Possibly evidenced by

  • Delirium, hallucinations
  • Drowsiness
  • Hypercapnia

Desired Outcomes

  • Vital signs of the kid will return to normal; the child is aware and oriented; motor, cognitive, and sensory function are within the child's age-appropriate ranges; and the specific urine gravity is normal.

Nursing Interventions

Rationale

Check your neurological state and vital indicators.

An alarming symptom of elevated ICP is an increase in systolic blood pressure that is accompanied by a decline in diastolic blood pressure.

Keep an eye out for any indications of elevated intracranial pressure.

Indicators of a rise in ICP include headache, fatigue, loss of alertness, vomiting, and a swollen fontanelle (infants).

Check for twitching, stiffness, increased restlessness, and irritation in the nuchal region.

These symptoms of meningeal irritation may result from an infection.

Keep an eye out for rising agitation, groaning, and protective actions.

These nonverbal signs might signify growing ICP or discomfort. Increased ICP can be potentiated by unrelieved pain.

ABGs (arterial blood gases) and oxygen saturation should be monitored.

Determines whether hypoxia is present and suggests the necessity for treatment.

Keep your head or neck in a neutral posture and give it a little cushion for support.

The jugular veins are compressed when the head is turned to one side, which prevents venous outflow and raises ICP.

Avoid bending your knees or pressing your heels towards the mattress while repositioning.

ICP rises as a result of these activities because they raise intra-thoracic and intra-abdominal pressures.

Reduce external stressors and offer comfort measures like a calm setting, a soothing voice, and gentle touch.

Produces a calming impact that lessens the body's negative physiological reaction and encourages sleep to keep or lower ICP.

Avoid neck and hip flexion and raise the head of the bed by 30 degrees.

Encourages venous outflow from the head, lowering the risk of elevated ICP and cerebral edema, and congestion.

As needed, provide oxygen.

Decreases hypoxia, which can lead to a rise in blood volume, cerebral vasodilation, and an increase in ICP.

Give the drugs as directed:

  • Mannitol is an osmotic diuretic (Osmitrol).

Increased cerebral blood flow is used to treat cerebral edema.

  • Anticonvulsants: phenytoin or diazepam (Valium) (Dilantin)

Used to manage seizures brought on by elevated intracranial pressure.

Meningitis Nursing Care Plan

2. Hyperthermia

Nursing Diagnosis

  • Hyperthermia

May be related to

  • Infection
  • Abnormal temperature regulation

Possibly evidenced by

  • Higher than usual body temperature
  • Flushed, hot skin
  • Higher heart rate
  • Accelerated breathing
  • Seizures

Desired Outcomes

  • Child's body temperature will return to normal and stay there.

Nursing Interventions

Rationale

Attentively examine the child's vital signs.

Typically, a temperature of up to 104°F appears at the beginning of an aseptic viral meningitis history. BP and HR also rise when heat worsens.

Examine the patient for dehydration symptoms such dry mouth, sunken eyes, fontanelle sunkenness, and poor flow of concentrated urine.

A higher metabolic rate results in a higher rate of insensible fluid loss when the body temperature is elevated.

Reduce the temperature gradually.

Shivering can be caused by a quick drop in temperature, which might have the opposite effect and raise the temperature instead of decreasing it.

Put tepid sponge to work.

reduces temperature by allowing heat to escape through conduction and convection.

Continue to drink as much liquid as you can handle.

Avoid fluid excess due to the danger of cerebral edoema to avoid dehydration.

Give antibiotics as directed.

In order to address the underlying causes of inflammation and hence stop seizure activity, antibiotics are administered.

As needed, provide antipyretics.

As fever raises the need for cerebral metabolism, antipyretics bring down temperatures and reduce the need for brain oxygen.

Meningitis Nursing Care Plan

3. Acute Pain

Nursing Diagnosis

  • Acute Pain

May be related to

  • The pressure inside the skull has risen
  • Inflammation of the meninges

Possibly evidenced by

  • Neck stiffness
  • Headache
  • Irritability
  • Nuchal rigidity

Desired Outcomes

  • Child will express emotions of alleviation from discomfort and contentment.

Nursing Interventions

Rationale

Identify any headaches or photophobia.

Meningitis also causes sensitivity to bright lights and inflammation of the meninges of the brain, which can result in excruciating migraines.

Check for the Brudzinski sign and the Kernig sign, which are discomfort and resistance with passive knee extension with the hips completely extended (hips flex on bending the head forward).

These are used to check for any meningeal irritation symptoms.

Maintain a calm atmosphere and keep the child's room dark.

A darker environment could lessen photophobia.

Limit guests and avoid excitement.

The discomfort may become more severe as a result of stimulation increasing intracranial pressure.

Manage the surroundings to promote slumber.

Environmental modifications like louder noise and brighter light contribute to sensory overload, which encourages brain inflammation and convulsions.

The client should be carefully positioned and turned often.

Reduces irritability and agitation while promoting comfort.

Encourage ROM exercises.

Prevent neck discomfort and joint stiffness.

As directed, administer the antibiotic and corticosteroid.

The use of antibiotics and corticosteroid treatment helps reduce discomfort by reducing inflammation.

As directed, give patients analgesics such as acetaminophen or NSAIDs.

NSAIDs are used to treat pain.

Meningitis Nursing Care Plan

4. Disturbed Sensory Perception

Nursing Diagnosis

  • Disturbed Sensory Perception

May be related to

  • Reduced LOC
  • Brain edoema
  • ICP increase
  • Hydrocephalus

 

Possibly evidenced by

  • Altered Sensory System

Desired Outcomes

  • The child's LOC will remain normal.

Nursing Interventions

Rationale

The Glasgow coma scale for children is used to determine state of consciousness.

Measurement of the motor, verbal, and sensory clues associated with LOC may be done accurately and objectively using the Glasgow Coma Scale. Determining the meningitis damage's degree with the use of a neurological

If the LOC continues to deteriorate, keep an eye out and let your doctor know.

Once the LOC further declines, more therapy or therapeutic adjustments may be necessary. Increased ICP with lower cerebral perfusion pressure may be indicated by changes in mentation, seizures, elevated blood pressure (BP), bradycardia, or respiratory problems.

Look out for symptoms of cerebral edema such as nausea, vomiting, neck discomfort, headaches, disorientation, and erratic breathing.

As the symptoms worsen, anoxia, vasodilation, or vascular stasis can cause cerebral edema as a result of the increased intracellular and extracellular fluid in the brain.

Test your ability to obey either basic or difficult instructions.

The involvement of the cerebral hemispheres results in impaired cognitive performance.

Suck, gag, blink, and cough protective reflexes are evaluated for existence or absence.

Reflexes not being present is a late symptom of rising ICP.

Examine the patient for symptoms of meningeal irritation, including headache, photobia, nuchal stiffness, opisthotonic posture, Kernig's sign, and Brudzinki's sign.

Meningeal symptoms are essential characteristics of meningeal irritation and result from meningeal and spinal root inflammation as well as a collection of infectious exudates.

With the client's head in a neutral posture, raise the head of the bed by 30° to 45°.

encourages the brain's venous outflow and aids in ICP reduction.

As necessary, reorient the client to the surroundings.

To support cognitive function, reality orientation is crucially significant.

Help with Diagnostic Procedures:

  • Electroencephalogram

  • CSF through a lumbar puncture

  • Ventriculogram, computed tomography, or magnetic resonance imaging

The next diagnostic test is performed to measure cerebral pressure and find any infectious organisms.

Observe and care for the patient when they are having a seizure.

Preventing complications and further brain injury during a seizure requires precise and proper care.

Maintain a calm atmosphere and lower the lights.

Prevents stimulus that could trigger or advance a convulsion episode.

After the first 24 hours, measure the pupil size every 3 hours, then every 6 hours.

Increased intracranial pressure (ICP) will cause fixed dilated pupils and unequal pupil diameters.

Observe the seizure pattern and frequency and record it. Inform your doctor if you are having seizures.

The necessity for further neurological testing, anticonvulsant drugs, and reevaluation of therapy are indicated by changes in seizure pattern. Typically, a seizure occurs before intracranial pressure rises (ICP). A proper infection treatment programme will prevent future worsening and keep the intracranial pressure within normal ranges.

Give parents the opportunity to help with child care.

Encourage improved coping and anxiety reduction.

Dispense and keep track of anticonvulsant medicine levels.

Anticonvulsants are employed both therapeutically and prophylactically. To prevent seizures, therapy entails maintaining therapeutic blood levels.

Meningitis Nursing Care Plan

5. Anxiety

Nursing Diagnosis

  • Anxiety

May be related to

  • Threat to a child's health or a change in that status.
  • Hospitalization of a kid is a threat to or alteration in the surroundings.

Possibly evidenced by

  • Increased concern that the child's condition could deteriorate
  • Expressed anxiety and concern about the child really being hospitalized and the severity of the condition

Desired Outcomes

  • Parents will feel decreased anxiety

Nursing Interventions

Rationale

Examine the causes, the degree, the symptoms, and the need for knowledge and assistance.

Explains the need for measures to ease anxiety and worry; such causes include dread and uncertainty about sickness, shame over having it, the possibility of losing one's parenting role, and loss of responsibility when hospitalization is required.

Determine whether the parents are feeling guilty about not realising the sickness was serious earlier; urge them to talk honestly about their thoughts.

Diminishes or prevents emotions of shame or blame.

Encourage others to voice their worries and make inquiries about the status of a sick child.

Allows for the expression of emotions and the securing of knowledge necessary to lessen worry.

Encourage the parent to remain with the kid or visit when possible, phone when worried if the child is in the hospital, help with care (holding, feeding, bathing, dressing, and diapering), and give details about the child's daily schedule.

reduces anxiety in the parent, allowing them to assist and care for the kid.

Encourage participation in decision-making and caring for needs.

encourages ongoing observation of a child's health to look for changes in their symptoms.

Inform students on the causes, symptoms, and behaviors of diseases.

relieves parents' worries.

Describe the purpose of any operations, the nature of the therapy, and the results of any diagnostic testing (specify).

Reduces the anxiety-inducing fear of the unknown.

Inform parents about the need of keeping children in their rooms for at least 24 hours or until a diagnosis is made and the effects of their antibiotic treatment start to show.

Provides a chance to identify the kind of meningitis and take action to stop the disease from spreading to anyone who comes into contact with the youngster.

When parents are able to listen, they should correct any misconceptions and provide answers in simple terms, repeating what other staff members and/or a doctor have said about the cause and spread of the disease.

Prevents unwarranted worry brought on by false information, beliefs, or discrepancies in the information.

Meningitis Nursing Care Plan

6. Deficient Knowledge

Nursing Diagnosis

  • Deficient Knowledge

May be related to

  • Not being exposed to information.

Possibly evidenced by

  • Request for details on drugs, warning signals, symptoms, and reportable behaviors.
  • General nursing throughout an infant's or child's convalescence

Desired Outcomes

  • Parents explain the cause and the proposed course of action.

Rationale

Examine parents' desire and interest in implementing care, as well as their understanding of the disease and methods for controlling and resolving it.

Encourages the use of a practical lesson plan to guarantee adherence to the prescribed treatment; avoids information repetition.

In order to teach about diseases, give clear information and explanations; utilise illustrations, brochures, videos, and models.

Ensures comprehension based on preparedness and capacity for learning; reinforces learning with visual assistance.

Give written directions and a timetable to follow, and remind parents to give their kid a full course of antibiotics. Include details about the action of the drug, dose and frequency, side effects, and expected outcomes.

Explains how to take prescribed medications to treat or prevent infection and disease-related seizures. Viral meningitis may be treated with medicines until a diagnosis is made, whereas bacterial meningitis is treated with antibiotics.

Help to create meals that incorporate nutritious fluids, calorie requirements, and the fundamental four categories for the appropriate age range.

Encourages healthy eating in a stepwise way that is pleasant.

Encourage parents to check for potential hearing impairment by following up.

encourages the detection of hearing loss (injury to 8th cranial nerve caused by meningitis).

Educate parents about the advantages of regular H. influenzae (type B) vaccination starting at 2 months of age and continuing for a total of 3 doses.

Data indicate that since the introduction of the vaccination, the incidence of this kind of meningitis has declined. The disease may also be prevented, and the transmission of infection to newborns who have not received the vaccine may be reduced.

Encourage students to get enough sleep and participate in play and stimulating activities that are age-appropriate (specify).

Rest is crucial for recovery, while stimulating activities are required for ongoing growth or to encourage stimulation in cases of developmental lag.

If a respiratory infection is present, teach parents to isolate their children for 24 hours or until the culture is negative.

Prevents the spread of germs to family members.

Teach patients to report any changes in behavior or level of consciousness, including increased temperatures, poor eating or anorexia, irritability, or a decline in hearing acuity.

Reveals the symptoms and telltale indications of an infection.

As soon as instructed, provide antibiotics according to the prescription (specify) based on a CSF analysis and throat cultures.

Manages current illness and stops additional infection spread (action of drug).

Provide moderate laxatives or stool softeners, refrain from using restraints, and stop or lessen sobbing bouts.

Reduces the risk of elevated ICP owing to straining during feces and prevents constipation.

Meningitis Nursing Care Plan

7. Risk for Injury

Nursing Diagnosis

  • Risk for Injury

May be related to

  • Impaired neuronal regulation function due to internal cause.

Possibly evidenced by

  • [not applicable]

Desired Outcomes

  • No harm will come to the child.

Nursing Interventions

Rationale

Measure the infant's head circumference to determine the neurologic state, which should be evaluated for changes in consciousness, behavior patterns, and pupillary/ocular responses suitable for age (specify when).

Information that gives hints about potential changes in intracranial pressure brought on by brain inflammation and related edema

To check for bradycardia and hypoxia, attach a respiratory and cardiac monitor.

As ICP continues and the body tries to reduce blood supply to the brain, an increase in intracranial pressure will cause a drop in pulse and respirations, a widening of the pulse pressure with an erratic pulse, and quick and shallow breathing.

Note any seizure activity, including the start, frequency, length, and kind of movements that occur before, during, or after the seizure; make sure the bed is covered; take any prescribed toys or items from the bed; and provide any anticonvulsants.

Protects against harm during a seizure, which is a meningitis consequence.

Allow for relaxation intervals between treatments or operations, create a calm setting free from bright lighting, decrease gentle handling and care of infants and children, and limit visitors if you're agitated.

Decreases irritation and encourages comfort and sleep.

Keep an eye on the baby or youngster, sit close by, and speak softly.

Gives infants and children only a small amount of stimulus when the condition is severe.

Position your body with your head lifted up to 30 degrees and use a sandbag to keep your head straight.

Reduces intracranial pressure by enabling blood to leave the brain by gravity or any jugular drainage blockages.

Reposition the child every two hours, positioning them for maximum comfort with the HOB slightly elevated, without a pillow on the bed, or on their side if nuchal rigidity is present. Avoid abrupt movements, such as lifting the head, and keep oxygen and suctioning equipment on hand for when they are required.

Maintains airway patency and avoids secretion blockage, which raises ICP and CO2 retention.

Describe the reasons for the elevated ICP and the significance of preventing any additional increases in ICP.

Enables comprehension of the life-threatening severity of this condition and the elevated ICP.

Inform parents of any changes in condition, the causes of any physical or mental changes, and any disease-related repercussions.

Increases awareness of the origins and potential symptoms of the condition.

Inform them of the cause of seizure activity, any further illness symptoms, and any necessary treatments.

Explains how to take responsibility for preventing and/or treating this behavior as well as seizure consequences.

Explain to parents the potential risks and the necessity for monitoring for elevated ICP; go through the symptoms and indicators of elevated ICP.

Enables continuing responsibility for maintaining neurologic state and treatment.

As soon as instructed, provide antibiotics according to the prescription (specify) based on a CSF analysis and throat cultures.

Manages current illness and stops additional infection spread (action of drug).

Give stool softeners, abstain from using restraints, and stop or lessen weeping outbursts.

Stops the Valsalva maneuver from increasing ICP.

 

I'm Deepak, an experienced nursing professional with a Master's degree in Medical Surgical Nursing. As the founder of nursing.in, I aim to share my knowledge and expertise in nursing by providing valuable insights and updates on the latest developments in the field. Stay informed and learn about new techniques and treatments through my blog.

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