Which nursing intervention is appropriate for a school-age child with bacterial meningitis?
OverviewWhat is meningitis?Meningitis is an infection of the membranes (meninges) surrounding the brain and spinal cord. Meningitis can be caused by a bacterial, fungal or viral infection. Meningitis can be acute, with a quick onset of symptoms, it can be chronic, lasting a month or more, or it can be mild or aseptic. Anyone experiencing symptoms of meningitis should see a doctor immediately. Show
What is bacterial meningitis?Acute bacterial meningitis is the most common form of meningitis. Approximately 80 percent of all cases are acute bacterial meningitis. Bacterial meningitis can be life threatening. The infection can cause the tissues around the brain to swell. This in turn interferes with blood flow and can result in paralysis or even stroke. Who gets bacterial meningitis?Children between the ages of 1 month and 2 years are the most susceptible to bacterial meningitis. Adults with certain risk factors are also susceptible. You are at higher risk if you abuse alcohol, have chronic nose and ear infections, sustain a head injury or get pneumococcal pneumonia. You are also at higher risk if you have a weakened immune system, have had your spleen removed, are on corticosteroids because of kidney failure or have a sickle cell disease. Additionally, if you have had brain or spinal surgery or have had a widespread blood infection you are also a higher risk for bacterial meningitis. Outbreaks of bacterial meningitis also occur in living situations where you are in close contact with others, such as college dormitories or military barracks. Symptoms and CausesWhat causes bacterial meningitis?The bacteria most often responsible for bacterial meningitis are common in the environment and can also be found in your nose and respiratory system without causing any harm. Sometimes meningitis occurs for no known reason. Other times it occurs after a head injury or after you have had an infection and your immune system is weakened. What are the symptoms of bacterial meningitis?You want to watch for high fever, headaches, and an inability to lower your chin to your chest due to stiffness in the neck. In older children and adults, you may see confusion, irritability, increasing drowsiness. Seizures and stroke may occur. In young children, the fever may cause vomiting and they may refuse to eat. Young children may become very irritable and cry. There may be seizures. Also, because the fluid around the skull may become blocked their heads may swell. The onset of symptoms is fast, within 24 hours. If allowed to progress, you can die from bacterial meningitis. Diagnosis and TestsHow is bacterial meningitis diagnosed?It is important that you seek immediate medical assistance if you suspect meningitis. Your doctor will conduct a physical exam. Your doctor will look for a purple or red rash on the skin. Your doctor will check your neck for stiffness and will exam hip and knee flexion. Your doctor will have to decide if the cause is bacterial, viral or fungal and will have to analyze your spinal fluid so a spinal tap will be ordered. Your blood and urine may also be analyzed as well as the mucous from your nose and throat. Management and TreatmentHow is bacterial meningitis treated?Bacterial meningitis is treated with antibiotics. A general intravenous antibiotic with a corticosteroid to bring down the inflammation may be prescribed even before all the test results are in. When the specific bacteria are identified, your doctor may decide to change antibiotics. In addition to antibiotics, it will be important to replenish fluids lost from loss of appetite, sweating, vomiting and diarrhea. PreventionIs bacterial meningitis contagious?You should encourage anyone who you have come into close contact with to seek preventative treatment. Anyone who you have had casual contact with should not be affected. Is there a vaccine for bacterial meningitis?Yes, there are two kind of vaccines available for meningitis in the United States. One type is called a meningococcal conjugate (MenACWY); brand names are Mentactra® and Menveo®. The other type is a Serogroup B meningococcal (MenB) vaccine; brand names are Bexsero® and Trumenba®. The Centers for Disease Control and Prevention (CDC) agency has specific guidelines regarding who should receive the vaccine. The CDC recommends MenACWY vaccine for:
The CDC recommends the MenB vaccine be given to people who are 10 years old or older who have risk factors for meningococcal disease. The CDC does not recommend the vaccine for:
The CDC recommends that the following individuals wait before receiving the vaccine or talk further with their doctor about the need for the vaccine:
Outlook / PrognosisCan bacterial meningitis be cured?There is a 10 percent death rate from bacterial meningitis, but if diagnosed and treated early enough, most people recover. Are there ever complications from meningitis?Unfortunately, if treatment is not undergone immediately, there may be permanent damage. Seizures, mental impairment, and paralysis may be life-long. ResourcesWhere can I learn more about meningitis?CDC Hotline: 800.232.4636 Which nursing intervention is used to prevent ICP in an unconscious child?Nursing Interventions
Interventions to lower or stabilize ICP include elevating the head of the bed to thirty degrees, keeping the neck in a neutral position, maintaining a normal body temperature, and preventing volume overload.
How long will the nurse maintain isolation of a child with bacterial meningitis?If Meningococcal Meningitis is suspected patients should be isolated and droplet precautions continued for 24 hours after administration of appropriate antibiotics.
When compared with adults Why are infants and children at an increase risk of head trauma?The reasons for this greater frequency of head injury in children can be demonstrated both anatomically and biomechanically. The child's head is proportionately larger than in the adult (Young, 1966).
What intervention should be beneficial in reducing the risk of Reye's syndrome?Reye's syndrome is a dangerous condition, and children and teenagers are at risk. Parents can reduce the risk by avoiding aspirin and making sure they vaccinate their children against chickenpox and flu.
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