Question

Meningitis bacterial risk factors?

Meningitis Viral risk factors?

Meningitis Viral Priority Interventions?

Meningitis Bacterial Priority Interventions?

Answer 1

Risk factors for bacterial meningitis:

Age: bacterial meningitis is common among those under age 20.

Immunosuppression

Comorbid conditions such as diabetes mellitus, hypo parathyroidism, chronic kidney failure

Splenectomy and sickle cell disease which increases the risk of meningitis secondary to encapsulated organisms.

Alcoholism and cirrhosis

Recent exposure to others with meningitis with or without prophylaxis.

Contiguous infection such as sinusitis

Dural defect ( eg. Surgical, traumatic)

HIV infection which predisposes to bacterial meningitis caused by encapsulated organisms primarily Streptococcus pneumoniae, and opportunistic pathogens.

Thalassemia major

Intravenous drug abuse

Ventriculopertoneal shunt

Risk factors for viral meningitis:

Compromised immune system: AIDS, diabetes, use of immunosuppressant drugs.

Age: viral meningitis occur in children less than 5 years.

Skipping vaccines: lncreases the risk for anyone who hasn't completed the recommanded vaccination schedule.

Contact with rodent droppings or urine( lymphocytic choriomeningitis virus)

Travel history

Intravenous drug abuse

Some cranial congenital deformities

Faecal contamination

Bite from an infected insects like mosquito etc

Viral meningitis interventions:

Monitor signs and neurological status of the patient.

Observe for any signs of increased intracranial pressure such as headache, vomiting, drowsiness, decresed alterness and bulging fontanelle in infants.

Monitor arterial blood gases and oxygen saturation to determine the presence of hypoxia.

Adminster oxygen as necessary

Ensure proper hydration.

Adminster medications when necessary

● Osmotic diuretics such as mannitol which is used to treat cerebral edema by promoting cerebral blood flow.

● Anticonvulsents such as diazepam or phenytoin

●Antivirals such as acyclovir

Bacterial meningitis intervention:

Nursing interventions	Rationales
Monitor vital signs and neurological status	Increasing systolic BP accompanied by decreasing diastolic BP is an ominous sign of increased ICP
Observe for any signs of increased intracranial pressure	Signs and symptoms that indicate an increase in ICP includes headache, vomiting, drowsiness, bulging fontanelle(infants)
Assess for nuchal rigidity, twitching, increased restlessness, irritability	These are signs of meningeal irritation, which may happen because of infection
Observe for increased restlessness, moaning, guarding behaviors	These nonverbal cues may indicate increasing ICP or pain. Unrelieved pain can potentiate increased ICP.
Monitor arterial blood gases and oxygen saturation	Determines presence of hypoxia and indicate therapy needs.
Maintain head or neck in midline position, provide small pillow for support	Turning head to one side compresses the jugular veins and inhibits venous drainage thereby increasing ICP
During reposition, avoid bending of the knee and pushing heels against the mattress	These activities increaseintra thoracic and intraabdominal pressure thereby increasing ICP
Provide comfort measures and decrease external stimuli such as quiet environment, soft voice and gentle touch	produces relaxing effect which decreases adverse physiologic response and promotes rest to maintain or lower ICP
Elevate the head of the bed 30degree and avoid neck flexion and hip flexion	promotes venous drainage from head, thereby reducing cerebral vasodilation and elevate ICP
Adminster oxygen as necessary	Used to treat cerebral edema by promoting cerebral blood flow

Adminster medications as indicated:

Osmotic diuretics such as mannitol which can be used to treat cerebral edema by promoting cerebral blood flow

Anticonvulsents such as diazepam or phenytoin which can be used to control seizures related to increased intracranial pressure.

Antibacterials such as pencillins, vancomycin, cephalosporins