A child is admitted to the pediatric unit with a diagnosis of suspected meningococcal meningitis. Which of the following nursing measures should the nurse do first?
A. Assess vital signs
B. Institute seizure precautions
C. Assess neurologic status
D. Place in respiratory isolation
Correct Answer: D. Place in respiratory isolation
The initial therapeutic management of acute bacterial meningitis includes isolation precautions, initiation of antimicrobial therapy, and maintenance of optimum hydration. Nurses should take necessary precautions to protect themselves and others from possible infection. The patient with suspected or confirmed N. meningitidis should follow droplet precaution. This should be continued until after 24 hours of effective antibiotics administration.
Option A: Prompt recognition and immediate initiation of treatment are of utmost importance in the management of bacterial meningitis. Patients can present with abnormal vital signs, including fever, tachypnea, tachycardia, and hypotension. Hypotension with elevated pulse rate is suggestive of early vascular instability.
Option B: Complications of meningococcal meningitis can arise early or late in the disease course and can adversely impact morbidity and mortality. Late complications of meningococcal meningitis include chronic pain, skin scarring, and neurologic impairment. Other common complications include hearing impairment, visual impairment, and seizures.
Option C: Assessment should be performed after the patient is placed on respiratory isolation in order to avoid infecting other patients. Prompt antibiotic administration, especially within one hour, has been proven to improve morbidity and mortality, as well as prevent complications such as increased intracranial pressure and septic shock.