ASSESSMENT
A patient presents with fever, neck stiffness, and altered mental status. What condition should the nurse suspect?
Bacterial meningitis.
What is the FIRST priority when bacterial meningitis is suspected?
Initiate droplet precautions.
What is the primary antibiotic used for bacterial meningitis in this scenario?
Ceftriaxone
What is the most life-threatening complication of bacterial meningitis?
Sepsis or increased ICP leading to brain herniation.
Why are droplet precautions required?
Meningitis can be transmitted via respiratory droplets.
A patient is unable to flex their neck forward without pain. What is this finding called?
Nuchal rigidity.
Why must antibiotics be started immediately in suspected bacterial meningitis?
To reduce mortality and prevent rapid progression of infection.
Why is Dexamethasone given in bacterial meningitis?
To reduce inflammation and cerebral edema.
Why are patients with meningitis at risk for seizures?
Inflammation and irritation of brain tissue.
When can droplet precautions be discontinued?
After 24 hours of effective antibiotic therapy.
A patient experiences hip and knee flexion when the neck is flexed. What sign is this?
Brudzinski’s sign.
To reduce mortality and prevent rapid progression of infection.
Signs of increased ICP (risk of brain herniation).
What is the role of Acetaminophen in meningitis management?
Reduce fever and metabolic demand.
What neurologic complication can result from untreated meningitis?
Permanent brain damage or death.
Why should a CT scan be performed before lumbar puncture in some patients?
To rule out increased ICP and prevent herniation.
A patient has resistance and pain when extending the knee while the hip is flexed. What sign is this?
Kernig’s sign.
Why should stimulation (lights, noise) be minimized in meningitis patients?
To reduce ICP and prevent neurologic deterioration.
Why may Phenytoin be prescribed?
To prevent or treat seizures.
Why can meningitis lead to increased ICP?
Inflammation causes cerebral edema.
A patient reports photophobia. Why does this occur?
Inflammation of the meninges increases sensitivity to light.
A patient becomes increasingly confused and develops decreased LOC. What complication should the nurse suspect?
Increased intracranial pressure or worsening infection.
A patient begins seizing. What is the priority intervention?
Protect airway and administer anticonvulsant such as Phenytoin.
Why is timing critical when administering antibiotics and corticosteroids together?
Dexamethasone should be given before or with the first antibiotic dose to reduce inflammation effectively.
A patient develops hypotension and tachycardia. What complication should be suspected?
Septic shock.
Why is early recognition of meningitis critical?
Rapid progression can lead to death within hours if untreated.