MENINGITIS

(By Ayu Prawesti, M.Kep)

Meningitis is an infection of the

meninges (protective membranes)
that surround the brain and spinal
cord.

Sign and symptoms In

older children and
adults

Signs and symptoms in

children

a very high fever with cold hands and

feet
they may feel agitated but not want to

be touched
they may cry continuously
some children can become very sleepy

and it may be difficult to wake them up

they may appear confused and

unresponsive
they may develop a blotchy red rash

that does not fade when you roll a glass

over it

severe headache
vomiting
high temperature (fever) of 38C

(100.4F) or over
stiff neck
sensitivity to light
rapid breathing
a general feeling of being unwell
a distinctive skin rash (although not

everyone will have this)

Types Of meningitis
bacterial meningitis, which is caused by

bacteria such as Neisseria meningitidis or

Streptococcus
pneumoniae
and
spread
through close contact
severe brain damage and infect the blood
(septicaemia).
viral meningitis, which is caused by viruses

that can be spread through

sneezing and poor hygiene

coughing,

Bacterial meningitis
Vaccination programmes have helped reduce the
number of different types of bacteria. However,
there are currently a number of bacteria that do not
have effective vaccines yet
Neisseria meningitidis bacteria (A, B, C, W, X, Y
and Z.)
Streptococcus pneumoniae bacteria (the body's
defence system)
middle ear infection (otitis media).

Viral meningitis
vaccination programmes have successfully (For

example, the measles, mumps and rubella

(MMR) vaccine )
There are still a number of viruses that can

cause viral meningitis. These include:

enteroviruses - a mild stomach infection
the herpes simplex virus - which can cause
genital herpes and cold sores

Cranial insult
Tissue edema
ICP meningkat
Compression of blood vessels
Cerebral blood flow
Edema arround ecroic tissue
ICP compresion of brainstem and respiratory center
Accumulation of CO2
Vasodilatasi
ICP
death

DIAGNOSTIC TEST
a blood test the presence of bacteria or

viruses
a lumbar puncture where a sample of
cerebrospinal fluid (CSF)
a computerised tomography (CT) scan
a chest X-ray to look for signs of infection

complication
hearing loss
problems with memory and concentration
problems with co-ordination and balance
learning difficulties
epilepsy
cerebral palsy a general term for a set of

conditions that affect movement and coordination

speech problems
vision loss

Meningitis vaccination
themeasles,mumpsandrubella(MMR)vaccination
themeningitisCvaccination
theDTaP/IPV/Hibvaccination,whichprovides

protectionagainstHibbacteria,diphtheria,whooping
cough,tetanusandthepoliovirus
thepneumococcalconjugatevaccine(PCV)

Treating meningitis
Antibiotics or Antiviral
At the same time you may also be given:
oxygen
intravenous fluids (through a vein)
steroids or other medication to help reduce

the inflammation (swelling) around your

brain
Pain killers for the headache
anti-emetics (anti-sickness) medicine for
the vomiting

Therapeutic management of
Meningitis
Isolation precautions.
Initiation of antimicrobial therapy, usually through IV infusion and in large doses.
Maintenance of optimum hydration through IV infusion.
Reduction of increased ICP.
Control of seizures.
Maintenance of ventilation.
Control of hypothermia or fever.
Correction of anemia.
Treatment of complications.

Nursing care plan of Meningitis

Altered tissues perfusion (cerebral) or

increased ICP related to cerebral edema
Position patient with head of bed elevated to

30 derajay
Avoid neck and hip flexion
Prevent constipation and straining with
defecation (void valsava manuver)
Managed elevated temp
Administer diuretic and coticoseroid
Administer cephalosporin , cefotaxime
Assess neurological function
Assess for sign of increase ICP

Impaired Physical Mobility related to

general weakness, neurologic deficit.

1. Assess the ability to mobilize.

2. Instead of positioning the patient every 2 hours.
3. Perform masage depressed parts of the body.
4. Perform passive ROM.
5. Monitor thromboembolism, constipation.
6. Consul at physiotherapist if necessary.

Hyperthermia related to the infection

process
Monitor the temperature every 2 hours.
Monitor vital signs.
Monitor for signs of dehydration.
Give anti pyrexia.
Give the drink a pretty 2000 cc / day.
Perform a cold compress and

warm/hypothermya blanket
Monitor signs of seizures.

Pain related to headche, muscle and

joint aches
Admister mild analgesia
Encourage gentle range of motion and leg

exercise
Massage muscles
Control environtment to encourage rest

Seorang laki-laki, 29 tahun, mengalami kecelakaan 3

tahun yang lalu, dan terjadi fraktur basis cranii sehingga
timbul otorhoe dan rhinorhoe, setelah dirawat lebih dari 3
bulan pasien dapat pulang ke rumah dengan beberapa
gejala sisa. Dua hari yang lalu, pasien kembali datang ke
RS dengan keluhan sakit kepala hebat disertai mual dan
muntah, serta demam dan menggigil. Dia juga
mempunyai riwayat batukbatuk yang lama dan pernah
minum obat selama 3 minggu saja karena mual dan malas
harus kontrol ke puskesmas. Sekarang pasien dirawat
dengan diagnosa klinis Meningitis dan rencana akan
dilakukan LP untuk menentukan penyebab meningitisnya.
Nn. W, seorang mahasiswa keperawatan yang sedang
praktik profesi diminta oleh perawat ruanganuntuk
merawat pasien tersebut.
Apa yang harus dilakukan Nn. W ?