Meningitis Nursing

Meningitis Nursing

Preliminary

Meningitis is an inflammation of the lining of the brain, spinal cord, or both. The cause is bacterial or viral, meningitis is often preceded by respiratory infections, throat, or signs and flulike symptoms. Sejumalah Neisseria meningitidis bacteria are common causes of meningitis. This disease has a high incidence in children under age 5, with a peak incidence in children aged 3 to 5 years. Severe form of meningitis meningococcemia that starts quickly and can cause death. The signs and symptoms include high fever, lethargy, chills, and a rash.

ASSESSMENT

Nerve

·-Seizure Seizures

§ Increasing intracranial pressure (ICT)

· Sunset eyes "(setting-sun sign)

· Rigidity

· Kernig's sign positive

· Brundzinzki's sign positive

· Reaction declining pupil

· Fidget

· Opisthotonos

· Pain head

· Crying with shrill sound

Breathing

· New just experienced a history of infection, sore throat, or signs and flulike symptoms

Gastrointestinal

· Vomiting

Integumentary

· Prominent crown

· Petechiae

· Cold extremities

· Rash

· Cyanosis

· Fever

Nursing Diagnosis

Impaired cerebral tissue perfusion related to increased ICT

Expected results

Children will not experience the signs of increased ICT

Intervention

1. Assess neurological status of children every 2 to 4 hours, record the signs of weakness, protrusion ubunubun (in infants), pupillary changes, or seizures

2. Monitor fluid intake and output every turn of duty

3. Monitor vital signs every 2 to 4 hours

4. Note the quality and tone of a child crying

Rational

1. Assessment of neurological status is often as a basis to identify early signs of improving ICT

2. Increased fluid volume will increase ICT

3. Sura shrill cry caused when the child indicated an increase ICT

Intervention

1. Perform prevention of seizures, such as using artificial airway and suction equipment and attach the mucus barrier bed.

2. Give anticonvulsan treatment, as directed.

3. During the seizure, give the action:

· Bantu children lying sideways in bed or floor, free from factors that inhibit the respiratory area

• Do not bind the child, but let the free encyclopedia

• Do not put anything in your child's mouth

· Assess the respiratory status of children

· Note the various movements of children and duration of seizures

Rational

1. Prevention will help the child fall, head injury, anoksia, choke, and die and reduce the risk of complications yanglain

2. Anticonvulsan treatment helps control seizures

3. This helps to protect children and follow-up action

· This step helps prevent falls and injury due to a surge of movement during the seizure

· Binding or strong movements in children cause the children suffered injury

· Trying to insert objects into the child's mouth can damage teeth and gums

Your child needs resuscitation immediately if you have apnea breathing during or after seizure

· Type this movement and duration of seizures help explain whether the type of seizures experienced by children

Nursing Diagnosis

Hipertemia associated with infection

Expected results

Child's body temperature will drop less than 100 ˚ F (37.8 ˚ C)

Intervention

1. Monitr child's body temperature every 2 to 4 hours,

2. Give antipyretics as directed

3. Give the antimicrobial, according to the instructions

4. Maintain a cool environment

5. Give compress (98.6 ˚ F [(37 ˚ C)], according to the instructions

Rational

1. Monitoring the temperature decrease

2. Antipyretics reduce fever are reduced to normal temperature

3. Antimicrobial handle infection

4. The cool environment will reduce fever through heat loss by radiation

5. Cold compress on the body surface by conduction.

Nursing Diagnosis

Lack of knowledge related to nursing home

Expected results

The parents will express pemahamannnya about home care instructions

Intervention

1. Teach parents how and when given the drug, including a description of the dosage and side reactions

2. Teach parents the importance of providing adequate breaks in children.

Rational

1. Understanding the importance of regular treatment can meninkatkan recovery. Knowledge of the possibility of side reactions of drugs allows parents to seek immediate care when needed

2. After the infection, which often breaks will improve recovery.

Check listing

During his stay in hospital, recording:

· Kindisi and assessment for children in hospital

· Changes in the child's condition

· Laboratory and diagnostic tests performed

· Child's neurological condition

· Intake and output fluid

· Food intake

· Status of growth and development

· Child treatment response

· Reactions parent to child illness and hospital stay

· Guidelines for health education to patients and their families

· Guide home plans

Myelomeningocele

INTRODUCTION

In myelomeningocele, a form that is often on spina bifida, in which the spinal column does not close perfectly, and there is a thin pouch padfa nbagian from the spinal cord, meningen, and spinal fluid protruding from the rear.

Hydrocephalus can occur 70% to 90% on all infants born with myelomeningocele which occurs both when in the womb or during the neonatal period.

Pengukuiran levels of alpha-fetoprotein in the fluid amniondapat help detect any abnormality, which occurs approximately 1 in a 1000 fight to live. The location of kelaianan will help memnentukan severity. For myelomeningocele and nerve channels kelaianan m, empunyai relationship with folic acid deficiency, women with childbearing age dapatmenurunkan risk by increasing intake of folic acid.

Potential complications include paralysis, joint disorder, meningitis, and reduced control of urination and defecation. Treatment includes surgery, antibiotic medication, physical therapy, exercise, urination and defecation. Many children can walk using a cane or splint.

ASSESSMENT

Nerve supply

· Decrease in level of consciousness

· Additions head circumference

· Prominent crown

· Letargy

· Irritability

Breathing

· Apnea

Gastrointestinal

· Vomiting

· Reduced reflex, sucking

Genitourinary

· Dysuria

· Retenmsi urine

· Urine drip-drip

· Incontinence

Integumentary

· Leakage of cerebrospinal fluid come out of the pocket formed

· Unstable body temperature

· Skin damage

Nursing Diagnosis

Damage to the integrity of the skin associated with terbnetuknya bags and surgical procedures

Expected results

Babies do not experience signs of postoperative infection is characterized by temperatures less than 100 ˚ (37.8 ˚), white blood cell count according to age, and no expenditure of purulent wounds.

Intervention

1. During the post-surgical and early postoperative period, maintaining a baby in a prone position with the buttocks higher than his head.

2. Use blankets or pillows of sand in order to maintain the baby moves from side to side

3. During the period prabedah, cover with sterile gauze bag with a solution of normal violations. Make sure that the place was covered with a new bandage which bandage can not be separated again from his place.

4. Test fluid flowing out of the bag for examination of glucose. Inform your doctor promptly if brain fluid dripping from the bag.

5. During the postoperative period, put a bandage on the upper buttocks pleister transparent under the bag

6. examined for signs of infection every 4 hours (including fever, increased white blood cells, and purulent fluid flow keluarg of bag) or convulsions.

7. Note the importance of washing hands with good technique on all visitors.

Rational

1. Tengkurang position will reduce the pressure on the bag, reducing the risk rupur.

2.Tindakan This helps maintain the infant in the prone position

3. Packaging is moist on top of the bag will maintain the membrane remains moist, helps prevent rips the bag and spending the brain caiueran Yeng belrebihan

4. Cerebrospinal fluid with a positive glucose test. Cerebrospinal fluid leaks pose a risk of meningitis.

5. Plastic bandage helps prevent contamination in the bag or surgical incision.

6. Assessments are often allows early detection and treatment of infections or seizures.

7. Good hand washing techniques to reduce the risk of infection.

Nursing Diagnosis

Hypothermia associated with loss of temperature through the bag

Expected results

Babies will maintain body temperature less dariu 100 ˚ F (27.8 ˚ C).

Intervention

1. During the postoperative period prabedah and early, put the infant and the incubator or heated.

2. Monitor the baby's body temperature every 4 hours the temperature probably unstable.

Rational

1. Due to leakage of the bag, the baby will increase the total surface area of ​​exposed skin. With memasdukkan into the incubator or pengkangat will minimize loss by convection and evaporation temperature of the skin permukasan.

2.Suhu satabil not a sign of major dysfunction or tanda0tanda initial infection, such as sepsis or meningitis.

Nursing DIANGNOISA

Impaired tissue perfusion serebralerbhubunagn with hydrocephalus and increased intracranial pressure (ICT)

Expected results

Babies do not have signs of increased intracranial pressure (bulging fontanel, increasing head circumference size, vomiting, and crying loudly.)

Inmtervensi

1. Assess the condition neurilogis every 2 to 4 hours, note any signs letargy, bulging fontanel, pupillary changes, or seizures.

2.Ukur baby's head circumference every day.

3.Kaji front crown baby every 4 to 8 hours.

4. Report possibility of pembengkakakn around or clear discharge from the back incision.

Rational

1. Engkajian neurological status as often as possible as a basis to identify any signs of hydrocephalus

2. Additions lebh size of the normal limit m, erupakan signs of hydrocephalus

3. Normally, the crown ahead will be closed at the age of 12 to 15 months. If that happens protrusion at the indicated increase in ICT.

4. Swelling or a discharge is an indication of hydrocephalus or infection perkemangan surgery (or both).

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