Pediatric Meningitis (Bacterial or Viral)
(Bacterial or Viral)
Risk for injury r/t generalized seizures, generalized weakness, or vertigo
Closely monitor temperature
Administer appropriate anti epileptic drug and utilize seizure precautions.
Ensure adequate hydration: monitor fluid status carefully. There may be inappropriate ADH secretions causing fluid retention (cerebral edema) and dilutional hyponatremia.
Monitor I&O, urine specific gravity closely
Frequently check signs of shock: tachypnea, tachycardia, delayed cap refill, increase in BP are early signs.
Ensure safety: keep bed in lowest position with sides of bed up (Patient may also have altered LOC
Impaired physical mobility r/t neuromuscular damage AEB decrease in strength
Assess degree of immobilization in the child frequently
Provide active or passive massage
Assist with passive ROM exercises
Set up consult with physical therapy
Allow for play in bed when child is feeling better
Encourage family to openly express feelings. Because the onset of meningitis happens suddenly, parents may feel guilty for not having suspected seriousness of illness earlier.
Explain to parents why patient must be placed on respiratory isolation and explain importance of adherence.
Keep parents informed of all procedures, results, and treatments.
Explain procedures to child using simple terms, stress that child has not been "bad," allow for play when child is feeling better.
Acute pain r/t meningeal inflammation AEB verbalization of pain/physiological manifestations
Assess vital signs and neurologic signs frequently
Assess pain frequently using Wong-Baker scale
Keep room quiet, dark, to avoid overstimulation and effects of photophobia. Minimize tactile stimulation.
Allow child to assume position of comfort. May choose side-lying position, or have neck hyper-extended.
Acetaminophen should be used cautiously as it can cover up fever. Determine if patient is febrile before administration.
Assess for signs of anxiety, give anti-anxiety medication as needed