Supervised By:
General Coordinator of Training at the Hospital:
Assistant Professor / Samah Mohamed
Dr/ Marwa Abd El-Rahman
Ms/ Samar Hussien
Ms/ Shrine Samy
Dr/ Aya Hesham
2024/2025
Prepared By:
Nourhan Karim
Hager Khaled Salah
Nermine Hesham
Hager Ibrahim Abd El-Rahman
Dina Samir
Hager Ibrahim Mohamed
Dina Attia
Mohamed Hassan
Mahmoud Abd El-Aleem
Table of Contents
-Introduction
-Definition
-Types
-Risk Factor
-Clinical Manifestation
-Diagnosis
-Treatment
-Nursing Diagnosis
Introduction
Meningitis is a disease caused by the inflammation of the
protective membranes covering the brain and spinal cord known
as the meninges.
The inflammation is usually caused by an infection of the fluid
surrounding the brain and spinal cord.
Meningitis can be life-threatening because of the inflammation's
proximity to the brain and spinal cord; therefore the condition is
classified as a medical emergency.
Definition
Meningitis is acute or chronic inflammation of the protective
membranes covering the brain and spinal cord, collectively
called the meninges
Symptoms of meningitis
Symptoms of meningitis develop suddenly and can include:
• a high temperature (fever)
• being sick
• a headache
• a rash that does not fade when a glass is rolled over it (but a
rash will not always develop)
• a stiff neck
• a dislike of bright lights
• drowsiness or unresponsiveness
• seizures (fits)
• These symptoms can appear in any order. You do not always
get all the symptoms
Types of meningitis
Non-infectious processes (autoimmune disorders,
cancer/paraneoplastic syndromes, drug reactions).
Infectious etiologic agents of meningitis include bacteria,
viruses, fungi, and less commonly parasites
Risk factors for meningitis include:
• Chronic medical disorders (renal failure, diabetes, adrenal
insufficiency, cystic fibrosis)
• Extremes of age
• Under vaccination
• Immunosuppressed states (iatrogenic, transplant recipients,
congenital immunodeficiencies, AIDS)
• Living in crowded conditions
• Exposures:
• Travel to endemic areas (Southwestern U.S. for cocci;
Northeastern U.S. for Lyme disease)
• Vectors (mosquitoes, ticks)
• Alcohol use disorder
• Presence of ventriculoperitoneal (VP) shunt
• Bacterial endocarditis
• Malignancy
• Dural defects
• IV drug use
• Sickle cell anemia
• Splenectomy
Diagnosis
• physical examination to look for symptoms of meningitis.
• lumbar puncture – where a sample of fluid is taken from the
spine and checked for bacteria or viruses.
• blood test to check for bacteria or viruses.
• CT scan to check for any problems with the brain, such as
swelling
Complication
• Increased intracranial pressure from cerebral edema caused by
increased intracellular fluid in the brain. Several factors are
involved in the development of cerebral edema: increased in
blood-brain barrier permeability, cytotoxicity from cytokines,
immune cells, and bacteria.
• Hydrocephalus
• Cerebrovascular complications
• Focal neurologic deficits
Nursing Interventions and Actions
1. Assessing Neurological Status and Improving Cerebral
Tissue Perfusion
2. In infants, head circumference should be measured daily.
Increased head circumference indicates increased intra-
cranial pressure.
3. Normalizing Body Temperature
4. Intravenous fluids as ordered.
5. When possible, raise the head of bed greater than 30
degree and maintain a neutral alignment.
6. Take precautionary measures to prevent infection. If
meningitis is infectious.
7. Managing Acute Pain
8. Improving Sensory Perception and Preventing Injuries
9. Reducing Anxiety
10. Initiating Patient Education and Health Teachings
11. after discharge, Neurodevelopmental progress will be
monitor in outpatient.
12. in children patients, tell the parents about the risk of
hearing loss. All patients treated for bacterial meningitis will
have a formal audiology assessment 6-8 weeks after
discharge.
13- nursing staff need to prioritise antibiotic treatment, as
delays are associated with poorer outcomes.
Treatment in hospital
• Antibiotics given directly into a vein.
• Fluids given directly into a vein to prevent dehydration.
• Oxygen through a face mask if there are any breathing
difficulties.
• Steroid medication to help reduce any swelling around the
brain, in some cases.
Treatment
Treatment depends on the type of meningitis.
Bacterial meningitis
New-onset bacterial meningitis needs treatment right away with
antibiotics given through a vein, called intravenous antibiotics.
Sometimes corticosteroids are part of the treatment. This helps
you recover and cuts the risk of complications, such as brain
swelling and seizures.
The antibiotic or mix of antibiotics depends on the type of germ
causing the infection. Until your healthcare professional knows the
exact cause of the meningitis, you may get a broad-spectrum
antibiotic that fights a range of germs.
Your healthcare professional may prescribe corticosteroids to
reduce swelling in the brain and a medicine to control seizures. If a
herpes virus caused your meningitis, you may get an antiviral
medicine.
Viral meningitis
Antibiotics can’t cure viral meningitis. Viral meningitis tends
to get better in a few weeks. Treatment of mild viral
meningitis includes:
• Bed rest.
• Plenty of fluids.
• Pain medicine to help reduce fever and relieve body aches
