Pathologic Conditions
- Definition: Inflammation of the membranes covering the spinal cord or brain.
- Pathophysiology: Microorganisms invade the meningeal area.
- Etiology: Most cases are of hematogenous origin (bloodborne organism is carried to meninges from another body site such as the respiratory or GI tract). Haemophilus influenzae (a bacteria) is the most common causative organism. Other bacteria, viruses, and fungi may also cause meningitis.
- Manifestations: Anorexia, fever (or decreased temp in the neonate), irritability, tense fontanel, stiff neck (nuchal rigidity), photophobia, seizures, opisthotonos, and positive Kernig’s and Brudzinski’s signs.
- Med Tx: Spinal tap to identify organism, antibiotics if cause is bacterial, isolation, and strict I&O.
- Nsg Dx: Pain; potential for injury; hyperthermia (hypothermia may occur in neonate); sleep pattern disturbance.
- Nsg Care: Frequently assess vital signs and neurologic status. Strictly monitor I&O. Measure head circumference daily if fontanel has not closed. Keep room quiet and lights dim. Elevate head of bed slightly. Encourage vaccination for Haemophilus influenzae in well children as preventive measure.
- Prognosis: Prognosis is good with prompt diagnosis and treatment. Residual complications may include hearing problems, seizures, development delays, attention deficit disorder, and mental retardation.