Wednesday, August 28, 2019
Bacterial Meningitis - Pediatric Research Paper
Bacterial Meningitis - Pediatric - Research Paper Example Diagnosing Bacterial Meningitis Bacterial meningitis is the inflammation of the meninges caused by bacteria, which may be fatal to the individual. It can be caused by several types of bacteria, of which the most common are Haemophilus influenzae type b (Hib), Streptococcus pneumoniae, and Neisseria meningitidis, affecting varied age groups. In children, clinical manifestations of the condition may be fever, stiff neck, headache, lethargy, irritability, nausea, vomiting, and photophobia, which are all non-specific but may suggest the diagnosis of bacterial meningitis when there is a combination of one or more of these symptoms (Scheld, Whitley, & Marra, 2004, p. 384). Through lumbar puncture (LP), the cerebrospinal fluid (CSF) is examined to confirm the diagnosis, but in cases where LP cannot be performed like in the presence of a focal intracranial mass lesion, a cranial computed tomography (CT) scan or a cranial magnetic resonance imaging (MRI) scan is obtained (p. 385). The respons ibility of the nurse is to conduct a thorough physical assessment and note the presence of Kernigââ¬â¢s and Brudzinskiââ¬â¢s signs. ... n important role in initiating supportive interventions to ensure proper ventilation, reduce inflammatory response, and prevent brain injury, with the goals of reducing intracranial pressure (ICP), maintaining cerebral perfusion, treating fluid volume deficits, controlling seizures, and providing safety measures (Kyle, 2008, p. 500). ADPIE In assessment, the nurse performs a neurologic examination that includes the six areas of neurologic functioning in order to gauge the extent of the clientââ¬â¢s mental state that would jeopardize his safety. He or she notes all aspects of the childââ¬â¢s health, including changes in feeding patterns. One of the priority diagnoses in bacterial meningitis is Risk for Injury related to decreased level of consciousness (LOC) secondary to meningeal irritation. Because there is decreased cerebral perfusion, the patient may experience altered consciousness that would compromise his or her safety. The aim of the nurse in her care is to provide safet y measures and prevent further complications, and educate the clientââ¬â¢s family on promoting a safe environment. The nurse monitors for fever, nuchal rigidity, or irritability, watches vital signs, and for increased ICP and altered responsiveness, in order to detect common sequelae such as subdural effusions or septic arthritis and ensure prompt treatment (ââ¬Å"Nursing Care,â⬠n.d.). It is also important to measure the intake and output of the client, with measuring urine specific gravity, restricting sodium, and obtaining daily weight to determine possible fluid retention and prevent cerebral edema. As shock is also possible to occur, the nurse continuously monitors vital signs, blood pressure, capillary refill, and level of consciousness in order to prevent the complication or quickly respond once
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