Nursing Care Plan for Meningitis

Pathophysiology

The meninges surround both the brain and the spinal cord to provide cushion and protection as well as create cerebrospinal fluid.  In meningitis, these meninges get infected and inflamed, causing symptoms that range from altered level of consciousness (due to inflammation in the brain) to nuchal rigidity or numbness & tingling (because of the effect on the spinal cord).

Etiology

Meningitis can be caused by bacteria or viruses, which can be introduced via the bloodstream as well as through invasive procedures or fractures of the skull.  Transmission is via droplets and usually occurs in areas of population density or crowded living spaces such as college dorms, prisons, and homeless shelters.

Desired Outome

Treat the underlying infection, decrease inflammation and swelling in the brain, and prevent long-term neurological deficits.

Meningitis Nursing Care Plan

Subjective Data:

  • Confusion
  • Lethargy
  • Photophobia
  • Headache

Objective Data:

  • Fever
  • Increased ICP
  • Seizures
  • Nuchal rigidity

Nursing Interventions and Rationales:

  1. Place patient in droplet isolation
    • Meningitis is spread via droplets, therefore a mask, gown, and gloves should be worn at all times and all surfaces should be cleaned thoroughly
  2. Administer analgesics and/or anti-inflammatories
    • To alleviate headache or nuchal rigidity caused by inflammation.
  3. Administer antimicrobials
    • Many antibiotics cannot cross the blood brain barrier, but will be given to treat any bloodstream infection. Antivirals can be given as well.
  4. Assess LOC and neuro status q2-4 hours
    • Inflammation of the meninges can cause irritation of the brain tissue and swelling, which can cause decreased LOC.
  5. Monitor ICP and CPP if available
    • If there is enough hydrocephalus or edema, providers may place an EVD for ICP monitoring. If so, monitor ICP and CPP hourly and manage EVD.
  6. Initiate seizure precautions
    • Inflammation of the meninges can cause irritation of the nerves and brain tissue, leading to development of seizures.
  7. Educate patient and family on infection control measures and s/s to report to provider
    • Handwashing is imperative, considering droplet transmission. Family members should also wash their hands on the way in and out of the room. Patients should report any s/s infection

References

Date Published - Nov 14, 2018
Date Modified - Nov 14, 2018