Nursing collage

2. Nursing Care Plan for Meningitis
Risk for Ineffective Cerebral Tissue Perfusion
.1
Nursing Assessment.
Subjective Data: The patient complains of headache, lethargy, and neck pain The patient’s mother reports
memory changes .
Objective Data: Positive Kernig’s and Brudzinski’s sign and CT scan shows ventriculitis
Nursing Diagnosis
Risk for ineffective cerebral tissue perfusion related to inflammation of the brain as evidenced by headache,
lethargy, neck pain, and memory changes.
Goal/Desired Outcome
Short-term goal: The patient’s intracranial pressure will remain normal and the patient will verbalize an
improvement of symptoms

3. Nursing Interventions Rationales
Monitor intracranial pressure and
neurological status
Meningitis can cause an increase of pressure in the brain which can lead to serious brain damage. Signs
and symptoms of increasing ICP include decreasing level of consciousness, vision changes, worsening
headache, seizures, and increased respiratory effort
Administer Mannitol as
prescribed
Mannitol is an osmotic diuretic that promotes cerebral blood flow and thus lowers ICP
Administer Dexamethasone as
prescribed
Dexamethasone is a steroid that lessens inflammation
If ICP remains high, prepare to
insert a lumbar drain
A lumbar drain is a small catheter inserted into the lower spine which facilitates the continuous drainage
of CSF
Keep the head and neck in midline
position and the bed elevated at
30 degrees
Turning the head can compress the jugular veins, preventing venous drainage and thus increasing ICP.
Head elevation promotes venous drainage
Limit visitors and promote a calm,
quiet, and dark environment
Minimizing stimulation helps decrease ICP. Darkness helps with the photophobia common with
meningitis

4. Nursing care plan with rationale for
Meningitis – Risk for shock
Nursing Assessment
Subjective Data:
The patient reports a recent upper
respiratory infection
Objective Data:
Temperature 38.5 C
HR 114 BPM
CSF is positive for gram-positive
streptococcus
Nursing Diagnosis
Risk for shock related to infection as