Medical Surgical Meningitis #4

Question

The nurse is caring for a client with meningitis. Which interventions will the nurse perform? Select all that apply

Answers

  1. Initiate seizure precautions
    • Rationale:

      This answer is correct because seizures are a complication of meningitis due to the inflammation and pressure in the brain. A seizure is a sudden uncontrolled electrical discharge in the brain. Seizure precautions include padding side rails, preventing injury, monitoring airway, no restraints, turning clients on side to prevent aspiration, and suctioning as needed.

  2. Assess for signs of intracranial pressure
    • Rationale:

      This answer is correct because meningitis can result in increased intracranial pressure. Increased intracranial pressure happens when the pressure inside the head increases due to inflammation. Symptoms include mental status change, bradycardia, irregular respirations, and high blood pressure with wide pulse pressure.

  3. Maintain client in a negative pressure isolation room
    • Rationale:

      This answer is not correct because meningitis is not airborne and therefore does not require a negative pressure isolation room. The meningitis client may be placed in isolation the first 24 hours before antibiotic therapy due to the direct contact and droplet precautions. After 24 hours of antibiotic treatment, the client is no longer considered contagious.

  4. Elevate HOB 30 degrees and avoid neck flexion
    • Rationale:

      This answer is correct because elevating the head of bed to 30 degrees reduces arterial pressure. Keeping the neck in a neutral position avoiding flexion, promotes venous drainage.

  5. Provide respiratory treatments
    • Rationale:

      This answer is not correct because respiratory treatments are not an intervention or treatment for meningitis. This intervention would be more appropriate for Guillain-Barre syndrome and amyotrophic lateral sclerosis.

Overview

Meningitis is inflammation of the meninges around the brain and spinal cord caused by bacteria, a virus or fungus. Interventions include monitoring vital signs and neurological signs, assessing for signs of intracranial pressure, monitor for seizure activity, elevate the head of bed 30 degrees, avoid neck flexion, and observe for nuchal rigidity and positive Kernig’s sign.

Explanation

Learning Outcomes

Meningitis is inflammation of the meninges around the brain and spinal cord caused by bacteria, a virus or fungus. Interventions include monitoring vital signs and neurological signs, assessing for signs of intracranial pressure, monitoring for seizure activity, elevating the head of bed 30 degrees, avoiding neck flexion, and observing for nuchal rigidity and positive Kernig’s sign. Seizure precautions include padding side rails, preventing injury, monitoring airway, no restraints, turning clients on side to prevent aspiration, and suctioning as needed. Meningitis can result in increased intracranial pressure. The nurse will observe for mental status changes, bradycardia, irregular respirations, and high blood pressure with wide pulse pressure. Elevating the head of bed to 30 degrees reduces arterial pressure. Keeping the neck in a neutral position and avoiding flexion promotes venous drainage. One of the most obvious symptoms of meningitis is Kernig’s sign. Stiffness to the hamstring to the point of an inability to straighten the leg while the hip is flexed to 90 degrees is Kernig’s sign.

Test Taking Tip

Know the interventions required for the meningitis client. They are similar to clients with increased intracranial pressure.

Video Rationale