Nursing care plan of Meningitis

Nursing diagnosis I : - Altered tissues perfusion (cerebral) related to cerebral edema, increased ICP, seizures. Nurse Goal (1): - The child will have normal neurologic status. - Intervention: the nurse must Establish neurologic baseline assessment and vital signs on admission. Monitor factors that may further increase cerebral edema and ICP (fever, seizures, hypercapnia). To decrease or prevent increasing the ICP : - organise nursing activities around periods of low ICP to prevent increasing ICP. - Monitor pupil size and reactivity / hour, when necessary or as ordered as sign of increased ICP. - Measure head circumference daily and document it in growth chart. - palpate the anterior fontanel and cranial suture every shift if age appropriate. - Monitor intake and output hourly. Notify physician if output is below 1 ml/kg/hr or 2 ml/kg/hr. - Assess the infant for irritability, lethargy and feeding intolerance. - place emergency equipment (such as oxygen, suction, ..) near the childs room or at bedside table. - Check urine specific gravity / 4-6 hrs or when necessary. - Notify physician if it is above 1.030 or less than 1.010.

Expected outcome of Meningitis The child has : - improved cerebral perfusion - normal level of consciousness

- vital signs in baseline - Glascow Coma Scale within normal limits and appropriate behaviour.

Nursing diagnosis II : - Altered nutrition: less than body requirements related to restricted intake; nausea, and vomiting, swallowing and chewing difficulty. Nurse Goal (1): - The childs weight will be stable and appropriate for age, normal serum protein, moist mucous membrane and adequate urine output. - Nausea and vomiting controlled. Nursing Intervention Weight the child daily on the same scale and record on growth chart. Monitor skin turgor, mucous membrane and urine output. Position the infant or child upright after feeding. Provide a flexible feeding schedule with small feedings of favourite foods. Minimise handling around feeding times. Assist the child with chewing with the childs chin and jaw in the nurses hand, if swallowing is impaired & if so feed by NG Tube. Consult dietician. Assess level of consciousness before giving liquids. Expected outcome The child shows normal growth and development, has nausea and vomiting under control, has adequate daily caloric intake and proper hydration.