Bacterial Meningitis Nursing Care Question.
A 6-month-old is admitted with bacterial meningitis.  Which action is the priority of care? (choose one of the following bacterial meningitis nursing care options, the answer and the explanation is given below)

1. Administering antibiotics
2. Avoiding environmental stimuli
3. Initiating seizure precautions
4. Measuring head circumference

 
Bacterial Meningitis Nursing Care Question Answer and Explanation:
Bacterial meningitis occurs when infection causes inflammation in the meninges of the brain and spinal cord.  This inflammation may lead to hydrocephalus and increased intracranial pressure (ICP).  Due to the risk for severe complications from meningitis and increased ICP (eg, hearing loss, permanent brain damage, death), the priority of care is immediate antibiotic therapy.  Lumbar puncture (LP) with cerebrospinal fluid culture is performed to determine the causative organism.  Antibiotic choice may be adjusted later based on LP results.  The client should remain on isolation precautions for a minimum of 24 hours following initiation of antibiotic therapy.
(Option 2)  Clients with meningitis are often very sensitive to stimuli (eg, bright lights, noise).  Although environmental stimuli should be reduced as much as possible, the priority of care is initiating antibiotic therapy.
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(Option 3)  Seizures may occur in infants with bacterial meningitis and are often accompanied by a shrill, high-pitched cry.  There is no indication that this client has experienced a seizure.  The nurse should carefully monitor for seizure activity and place the client on seizure precautions if necessary.  However, antibiotic therapy is the most critical intervention in treating bacterial meningitis.
(Option 4)  Although obtaining an initial head circumference is necessary to monitor for changes related to increasing ICP, the priority is obtaining blood cultures and administering antibiotics as soon as they are prescribed.
Educational objective:
Due to the risk for severe complications (eg, hearing loss, permanent brain damage) associated with bacterial meningitis, the most critical intervention is initiation of antibiotic therapy.  The causative organism is confirmed through LP and blood cultures.