Page 1111 - Saunders Comprehensive Review For NCLEX-RN

A. Description
1. Meningitis is an infectious process of the central
nervous system caused by bacteria or viruses that
may be acquired as a primary disease or as a result of
complications of neurosurgery, trauma, infection of
the sinuses or ears, or systemic infections.

2. Diagnosis of bacterial meningitis is made by

testing CSF obtained by lumbar puncture; the fluid is
cloudy with increased pressure, increased white
blood cell count, elevated protein, and decreased
glucose levels.
3. Bacterial meningitis can be caused by various
organisms, most commonly Haemophilus influenzae
type b, Streptococcus pneumoniae, or Neisseria
meningitidis; meningococcal meningitis occurs in
epidemic form and can be transmitted by droplets
from nasopharyngeal secretions.
4. Viral meningitis is associated with viruses such as
mumps, paramyxovirus, herpesvirus, and
enterovirus.

B. Assessment

1. Signs and symptoms vary, depending on the type, the
age of the child, and the duration of the preceding
illness.
2. Fever, chills, headache
3. Vomiting, diarrhea
4. Poor feeding or anorexia
5. Nuchal rigidity
6. Poor or high, shrill cry
7. Altered level of consciousness, such as lethargy or
irritability
8. Bulging anterior fontanel in an infant
9. Positive Kernig’s sign (inability to extend the leg when
the thigh is flexed anteriorly at the hip) and
Brudzinski’s sign (neck flexion causes adduction and
flexion movements of the lower extremities) in
children and adolescents
10. Muscle or joint pain (meningococcal infection and H.
influenzae infection)
11. Petechial or purpuric rashes (meningococcal infection)
12. Ear that chronically drains (pneumococcal meningitis)

C. Interventions

1. Provide respiratory isolation precautions and maintain
it for at least 24 hours after antibiotics are initiated.

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