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).
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.
Treat the underlying infection, decrease inflammation and swelling in the brain, and prevent long-term neurological deficits.
Meningitis Nursing Care Plan
- Increased ICP
- Nuchal rigidity
Nursing Interventions and Rationales
- Place the 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
- Administer analgesics and/or anti-inflammatories
To alleviate a headache or nuchal rigidity caused by inflammation.
- 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.
- 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.
- 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.
- Initiate seizure precautions
Inflammation of the meninges can irritate the nerves and brain tissue, leading to the development of seizures.
- Educate patient and family on infection control measures and s/s to report to the 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
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
For more information, visit www.nursing.com/cornell