Implementation of Nursing Care

Isolate the Child: When the child is admitted with suspected meningitis, the nurse has to take care that child's isolation is essential to protect other patients, health personnel and others who come in contact with the child. Proper isolation techniques including strict handwashing needs to be observed and the parents of the child need to be instructed accordingly.

Administer Drugs and Control Seizures: The drugs such as antibiotics are administered intravenously for a minimum 7 to 10 days. The choice of antibiotics usually depends upon the organism identified. The antibiotics commonly used are ampicillin given intravenously in the dose of 300 to 400 mg per kg per day in four divided doses. In newborns a low dose of ampicillin is combined with gentamicin
6 mg per kg per day or kanamycin 10 to 15 mg per kg per day. Cloxacillin 50- 100 mg per kg per day in divided doses is given in staphylococcal infection. In case of pencillin hypersensitivity chloramphenical in the dose of 50 to 100 mg per kg per day is given. You need to be cautious in regulating and administering accurate and appropriate dose of the these drugs and need to keep the intravenous route patent by canula or catheters.

For controlling seizures phenobarbitone 10 mg is given intravenously, dizepam 2.5 mg may be used and Dilantin in the dose of 7 mg per kg be given in stat dose intravenously as per advise of Physician.
Since the child is prone to seizures the child must be protected from injury and protective bed material may be used and level of consciousness of the child and neurological signs must be monitored carefully. Vital signs should be monitored and obtained frequently.

Maintain Fluid Intake and Provide Adequate Diet: If the child is unconscious, intravenous fluids are given and the rate of the flow is monitored accurately. If the child's health status permits then oral fluids and feeds'are given but you need to be quite alert to the change in sensorium of the child which may contraindicate oral fluids and feeds. Output record is maintained to assess any fluid retention.

In unconscious patient frequent mouth care is given. The diet should be rich in protein, calories and vitamins. If the child is  nconscious he may be fed through nasogastric tube feed and adequate care need to be taken in cleanliness of the nasal and oral
passages and location of tube and intake of the diet.

Provide Rest and Comfort: The environment should be kept as quiet as possible. If the child has photophobia, bright light may increase the child's discomfort. Child should be positioned in sideline position. Take care of the child while moving him from the bed or holding the head. In infants neck should be supported while holding the head. Some children do not feel comfortable with pillow and like to have head of the bed elevated.
Other comfort measures include prevention of bed sores by repeated change of position, application of methylated spirit, keeping the skin clean and dry applying powder and using SOH foam rubber matress or air cushion.