Bacterial Meningitis in Children
Pathophysiology
Teaching Points
Teach parents the risk factors and prevention methods
Keep patient hydrated
Reassure that this occurs naturally and is no one's fault
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Expected outcomes
Hearing loss (partial or total)
Epilepsy
Characterized by entry of bacteria into CSF with bacterial growth in this compartment causing inflamation in the CSF and adjacent brain tissue
Problems with memory and concentration
Crosses BB barrier
Membranes become infected, swell and press on the spinal cord or brain, causing life threatening problemss
Symptoms strink suddenly and worsen quickly
Partial/total hearing loss, need hearing test within a few weeks
Recurrent seizures
Coordination, movement, balance problems
Learning difficulties and behavior problems
Partial or total vision loss
Amputation if infection spreads to limbs
Kidney problems
Bone and joint problems (arthritis)
Safety Considerations
Inflammation associated with meningitis can lead to damage of the brain tissue, which in turn can lead to permanent neurological problems such as hearing loss, seizures, and cognitive impairment. This is a safety concern, and nurses should conduct regular focused neurological exams to monitor for any signs of neurological deficits.
Another safety concern is falls, as the child may experience psychomotor impairment. The child may experience respiratory distress/failure resulting from hypoxia or brain damage, meaning respiratory status should be assessed frequently.
Nursing interventions and nursing care
Interventions:
-Monitor vitals
-Assess for signs os increasing ICP
-Monitor seizure acitivity
-isolation precautions
-Elevate HOB
-Administer meds
-neurological assessment
Assessment:
-assess for LOC, headache, N+V, tachycardia, kernigs sign, brudzinskis sign, rash and lethergy
Pharmacology
First line of choice include ceftriaxone or penicillin and must be finished to completion
Hydration: ensure balance of fluid and electrolytes is WNL
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There is also a risk of pressure injury and skin breakdown if the child is immobile for long periods of time or incontinent.
Labs and Diagnostic Tests
Lumbar Puncture
CSF Analysis
CT and MRI
Blood Cultures
Urine Culture