Culture and sensitivity: Results may take up to 72 hours.
Blood cultures to identify the microorganism that is causing the infection.
CT brain to rule out space-occupying lesion as cause of symptoms.Treatment
Administer antibiotics as soon as possible to improve outcome for bac-
terial meningitis:- Penicillin G
- Ceftriaxone
- Cefotaxime
- Vancomycin plus ceftriaxone or cefotaxime
- Ceftazidime
Fungal infections are typically treated with - Amphotericin B
- Fluconazole
- Flucytosine
Administer corticosteroid to decrease inflammation in pneumococcal
infection: - Dexamethasone
Administer osmotic diuretic for cerebral edema: - Mannitol
Administer analgesics for headache if needed: - Acetaminophen
Administer anticonvulsant if necessary: - Phenytoin, phenobarbital
Administer Decadron (IV) every 6 hours for 4 days to reduce hearing
loss and severe neurologic damage.
Bed rest until neurologic irritation improves.
Administer D5/0.22 NSS IV plus potassium (two thirds of maintenance
fluids requirements) to reduce intracranial pressure.
No oral fluids.
Fluid restriction.
Nursing Intervention
Monitor intake and output to check fluid balance.
Keep room darkened due to photophobia.
Keep room quiet. Place Quiet sign on the door.
Monitor neurologic function at least every 2 to 4 hours, changes in men-
tal status, level of consciousness, pupil reactions, speech, facial move-
ment symmetry, signs of increased intracranial pressure.
Seizure precautions per institution policy.
Isolation per policy depending on organism (meningococcal).
Cluster care activities.CHAPTER 10/ Neurologic Conditions^207