Protection/Adaptation

Chapter 44: Meningitis &

Encephalitis

Copyright 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.

Meningitis Case Study

J.S., a 20-year-old college student, is brought to
the emergency department by her roommate.
J.S. states she awoke from an afternoon nap with
a severe headache and a stiff neck. She has
vomited several times and complains that light
hurts her eyes. Her roommate states that J.S. is
also "acting weird and just isn't herself." J.S.'s
past medical history is negative except for
seasonal allergies and recurrent sinus infections.
Vital signs on admission are as follows: BP
150/70, HR 104, RR 18, Temp 102 F (38.9 C).

Copyright 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.

Meningitis Case Study

While admitting J.S., what other questions about her
symptoms should you ask her? Select only the
responses that would pertain to clinical
manifestations of meningitis.

1. Have you had a recent sinus infection?

2. Can you describe how your headache feels to you?
3. Are your eyes sensitive to light?
4. Have you been under a lot of stress lately?
5. When was your last menstrual period?
Copyright 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.

Meningitis Case Study

The health care provider performs a lumbar puncture after
affirming there is no obstruction in the foramen magnum via
CT scan. The results confirm the presence of bacterial
meningitis. Indicate what these results would be by an "I" if the
result would be increased or a "D" if the result would be
decreased. Use either "Cloudy" or "Clear" for appearance.

Pressure?
WBC count?
Protein?
Glucose?
CSF appearance?
Copyright 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.

Meningitis Case Study

J.S. is admitted to a clinical unit with the diagnosis
of bacterial meningitis. Identify the appropriate
nursing care.

1. Quiet environment
2. Hourly position changes
3. HOB elevated
4. Intravenous morphine drip
5. Frequent stimulation to maintain orientatin
Copyright 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.

Meningitis Case Study

Your plan of care includes frequently monitoring
J.S. for complications. Which complication is
J.S.mostat risk for developing?

1. Seizures
2. Pneumonia
3. Organ failure
4. Thrombophlebitis

Copyright 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.

Encephalitis
Describe how the nursing care would change
with a patient with encephalitis.

Copyright 2013, 2010, 2006, 2002 by Saunders, an imprint of Elsevier Inc.