Question

Case Study

Assessing Neurologic System

A nurse is caring for a 48-year-old man diagnosed with meningitis after a head injury. The client was driving a motorcycle while on vacation and was not wearing a helmet. It had started to rain, and the client’s motorcycle swirled onto a grassy area. He fell off the motorcycle and landed on the ground. The client hit his head and suffered cuts and abrasions to his face, arms, and legs from the fall. He was taken to the emergency department of the local hospital by paramedics. Upon examination, the physician ordered a head CT scan and a brain MRI to determine if any head trauma had occurred. Both exams revealed negative findings, and the client was sent home after a 24-hour stay at the hospital for observation. The client was to return in 1 week for follow-up unless symptoms developed. Three days after the accident, the client began to have severe headaches, nausea and vomiting, blurred vision, and an oral temperature of 103°F. The client returned to the emergency department, and a diagnosis of meningitis was confirmed. The client was admitted and started on IV antibiotics. The next morning, the client asks the nurse “What is going on? I left the hospital 3 days ago and I felt fine.”.

What past health concerns should the nurse focus on?

Answer 1

Meningitis is an inflammation of the membranes surrounding your brain and spinal cord. Most common causes are viral bacterial and fungal infections .Bacteria enters the bloodstream and travel to the brain and spinal cord cause acute bacterial meningitis. It can also occur when bacteria directly invade the meninges by an ear or sinus infection and a skull fracture. Bacterial meningitis is usually life threatening.

In this case nurse need to focus on the past health concerns because the patient had a fall from motorcycle four days ago and developed a head injury. No head trauma detected in brain CT and brain MRI findings. Patient had a head injury after the fall, so the reason for the meningitis could be the bacteria entry through the blood sream and reached in the meningeal layer and cause infection. So you start develope severe head ache, nausea, vomiting, blurred vision and oral fever. We started antibiotics from yesterday and you will get well sooner.