Page 2035 - Saunders Comprehensive Review For NCLEX-RN

1. An inflammation of the arachnoid and pia mater of the
brain and spinal cord
2. It is caused by bacterial and viral organisms, although
fungal and protozoan meningitis also occur.
3. Predisposing factors include skull fractures, brain or
spinal surgery, sinus or upper respiratory infections,
the use of nasal sprays, and a compromised immune
system.

4. CSF is analyzed to determine the diagnosis

and type of meningitis. In meningitis, CSF is cloudy,
with increased protein, increased white blood cells,
and decreased glucose counts.
B. Transmission: Transmission occurs in areas of high population
density, crowded living areas such as college dormitories, and
prisons.

Transmission of meningitis is by direct contact, including droplet spread.

C. Assessment (see Box 58-4)

1. Mild lethargy
2. Photophobia
3. Deterioration in the level of consciousness
4. Signs of meningeal irritation, such as nuchal rigidity
and a positive Kernig’s sign and Brudzinski’s sign
5. Red, macular rash with meningococcal meningitis
6. Abdominal and chest pain with viral meningitis
D. Interventions
1. Monitor vital signs and neurological signs.
2. Assess for signs of increased ICP.
3. Initiate seizure precautions.
4. Monitor for seizure activity.
5. Monitor for signs of meningeal irritation.
6. Perform cranial nerve assessment.
7. Assess peripheral vascular status (septic emboli may
block circulation).
8. Maintain isolation precautions as necessary with
bacterial meningitis.
9. Maintain urine and stool precautions with viral
meningitis.

10. Maintain respiratory isolation for the client

with pneumococcal meningitis.
11. Elevate the head of the bed 30 degrees, and avoid neck
flexion and extreme hip flexion.

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