Nursing Care Plans for Meningitis – Best Nursing Care Plans(2022)

This article discusses Nursing Care Plans for Meningitis plus its causes, symptoms, preventions, treatments, and interventions.

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Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students for learning purposes only and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.


Meningitis is an inflammation of the fluid and membranes (meninges) surrounding the brain and spinal cord.

A viral infection causes most cases of meningitis in the United States, but bacterial, parasitic, and fungal infections are other causes. Some cases of meningitis improve without treatment in a few weeks. Others can be life-threatening and require emergency antibiotic treatment.

Nursing Care Plans for Meningitis – Pathophysiology of Meningitis

  • Most cases of meningitis are caused by an infectious agent that has colonized or established a localized infection elsewhere in the host.
  • The organism invades the submucosa at these sites by circumventing host defenses (e.g., physical barriers, local immunity, and phagocytes or macrophages).
  • Invasion of the bloodstream and subsequent seeding is the most common mode of spread for most agents.
  • Meningeal seeding may also occur with a direct bacterial inoculate during trauma, neurosurgery, or instrumentation.
  • The blood-brain barrier can become disrupted; once bacteria or other organisms have found their way to the brain, they are somewhat isolated from the immune system and can spread.
  • When the body tries to fight the infection, the problem can worsen; blood vessels become leaky and allow fluid, WBCs, and other infection-fighting particles to enter the meninges and brain; this process, in turn, causes brain swelling and can eventually result in decreasing blood flow to parts of the brain, worsening the symptoms of infection.
  • Replicating bacteria, increasing numbers of inflammatory cells, cytokine-induced disruptions in membrane transport, and increased vascular and membrane permeability perpetuates the infectious process in bacterial meningitis.

Nursing Care Plans for Meningitis – Symptoms of Meningitis

Early meningitis symptoms may mimic the flu (influenza). Symptoms may develop over several hours or over a few days.

Possible signs and symptoms in anyone older than the age of 2 include:

  • Sudden high fever
  • Stiff neck
  • Severe headache that seems different from normal
  • Headache with nausea or vomiting
  • Confusion or difficulty concentrating
  • Seizures
  • Sleepiness or difficulty waking
  • Sensitivity to light
  • No appetite or thirst
  • Skin rash (sometimes, such as in meningococcal meningitis)

Signs in newborns

Newborns and infants may show these signs:

  • High fever
  • Constant crying
  • Excessive sleepiness or irritability
  • Difficulty waking from sleep
  • Inactivity or sluggishness
  • Not waking to eat
  • Poor feeding
  • Vomiting
  • A bulge in the soft spot on top of a baby’s head (fontanel)
  • Stiffness in the body and neck

Infants with meningitis may be difficult to comfort and may even cry harder when held.

Nursing Care Plans for Meningitis – Causes of Meningitis

Viral infections are the most common cause of meningitis, followed by bacterial infections and, rarely, fungal and parasitic infections. Because bacterial infections can be life-threatening, identifying the cause is essential.

Bacterial meningitis

Bacteria entering the bloodstream and traveling to the brain and spinal cord cause acute bacterial meningitis. But it can also occur when bacteria directly invade the meninges. This may be caused by an ear or sinus infection, a skull fracture, or — rarely — some surgeries.

Several strains of bacteria can cause acute bacterial meningitis, most commonly:

Streptococcus pneumoniae (pneumococcus). This bacterium is the most common cause of bacterial meningitis in infants, young children, and adults in the United States. It more commonly causes pneumonia or ear or sinus infections. A vaccine can help prevent this infection.

Neisseria meningitidis (meningococcus). This bacterium is another leading cause of bacterial meningitis. These bacteria commonly cause an upper respiratory infection but can cause meningococcal meningitis when they enter the bloodstream. This is a highly contagious infection that affects mainly teenagers and young adults. It may cause local epidemics in college dormitories, boarding schools, and military bases. A vaccine can help prevent infection. Even if vaccinated, anybody who has been in close contact with a person with meningococcal meningitis should receive an oral antibiotic to prevent the disease.

Haemophilus influenzae (Haemophilus). Haemophilus influenzae type b (Hib) bacterium was once the leading cause of bacterial meningitis in children. But new Hib vaccines have greatly reduced the number of cases of this type of meningitis.

Listeria monocytogenes (listeria). These bacteria can be found in unpasteurized cheeses, hot dogs, and lunchmeats. Pregnant women, newborns, older adults, and people with weakened immune systems are most susceptible. Listeria can cross the placental barrier, and infections in late pregnancy may be fatal to the baby.

Viral meningitis

Viral meningitis is usually mild and often clears on its own. Most cases in the United States are caused by a group of viruses known as enteroviruses, which are most common in late summer and early fall. Viruses such as herpes simplex virus, HIV, mumps virus, West Nile virus, and others also can cause viral meningitis.

Chronic meningitis

Slow-growing organisms (such as fungi and Mycobacterium tuberculosis) invade the brain’s membranes, and fluids cause chronic meningitis. Chronic meningitis develops over two weeks or more. The signs and symptoms of chronic meningitis — headache, fever, vomiting, and mental cloudiness — are similar to those of acute meningitis.

Fungal meningitis

Fungal meningitis is relatively uncommon in the United States. It may mimic acute bacterial meningitis. It’s often contracted by breathing in fungal spores that may be found in soil, decaying wood, and bird droppings. Fungal meningitis isn’t contagious from person to person. Cryptococcal meningitis is a common fungal form of the disease that affects people with immune deficiencies, such as AIDS. It’s life-threatening if not treated with an antifungal medication. Even with treatment, fungal meningitis may recur.

Parasitic meningitis

Parasites can cause a rare type of meningitis called eosinophilic meningitis. A tapeworm infection can also cause parasitic meningitis in the brain (cysticercosis) or cerebral malaria. Amoebic meningitis is a rare type that is sometimes contracted through swimming in fresh water and can quickly become life-threatening. The main parasites that cause meningitis typically infect animals. People are usually infected by eating foods contaminated with these parasites. Parasitic meningitis isn’t spread between people.

Other meningitis causes

Meningitis can also result from noninfectious causes, such as chemical reactions, drug allergies, some types of cancer, and inflammatory diseases such as sarcoidosis.

Nursing Care Plans for Meningitis – Risk factors of Meningitis

Risk factors for meningitis include:

Skipping vaccinations. Risk rises for anyone who hasn’t completed the recommended childhood or adult vaccination schedule.

Age. Most cases of viral meningitis occur in children younger than age 5. Bacterial meningitis is common in those under age 20.

Living in a community setting. College students living in dormitories, personnel on military bases, and children in boarding schools and child care facilities are at greater risk of meningococcal meningitis. This is probably because the bacterium is spread through the respiratory route and spreads quickly through large groups.

Pregnancy. Pregnancy increases the risk of listeriosis — an infection caused by listeria bacteria, which may also cause meningitis. Listeriosis increases the risk of miscarriage, stillbirth, and premature delivery.

Compromised immune system. AIDS, alcoholism, diabetes, the use of immunosuppressant drugs, and other factors that affect the immune system also make a person more susceptible to meningitis. Having the spleen removed also increases the risk, and anyone without a spleen should get vaccinated to minimize that risk.

Nursing Care Plans for Meningitis – Complications of Meningitis

Meningitis complications can be severe. The longer a person has the disease without treatment, the greater the risk of seizures and permanent neurological damage, including:

  • Hearing loss
  • Memory difficulty
  • Learning disabilities
  • Brain damage
  • Gait problems
  • Seizures
  • Kidney failure
  • Shock
  • Death
  • With prompt treatment, even people with severe meningitis can have a good recovery.

Nursing Care Plans for Meningitis – Diagnosis of Meningitis

Physical examination and history taking –to check for any signs and symptoms of meningitis

Blood tests – full blood count may show elevated WBCs, which indicate an active infection; blood cultures and Gram’s stain will reveal the pathogen responsible for the infections; kidney function test may show any kidney problems as complications for severe meningitis

Imaging – MRI or CT scan of the head will be performed to check for any inflammation or swelling; chest or sinus X-ray may be done to check for any infection that might have traveled to the brain via the bloodstream

Lumbar puncture – also known as a spinal tap, is done by collecting cerebrospinal fluid (CSF) from the lumbar area of the spine to check for any signs of meningitis, such as elevated WBCs and protein, low glucose level, and the causative agent

Nursing Care Plans for Meningitis – Treatment for Meningitis


Bacterial meningitis is urgently treated with antibiotics intravenously. The type of antibiotics depends on the specific bacteria that have caused the infection, but the doctor may prescribe broad-spectrum antibiotics at first while waiting for the blood culture and spinal tap results. A patient with bacterial meningitis is likely to be placed in an isolation room to prevent the further spread of the infection.

Symptomatic treatment

Viral meningitis may benefit from antiviral medications (such as in the case of herpes virus), but mild cases of viral meningitis resolve for at least 7 days even without treatment. Bed rest, increased fluid intake, and over-the-counter antipyretics and pain medications are included in the treatment of viral meningitis. Antifungal medications are used for chronic fungal meningitis. Corticosteroids may be prescribed to relieve the swelling in the brain.

Nursing Care Plans for Meningitis Based on Diagnosis

Nursing Care Plans for Meningitis – Care Plan 1: Diagnosis  Ineffective Tissue Perfusion (Cerebral)

Related to cerebral edema and increased intracranial pressure (ICP) secondary to meningitis

Evidenced by drowsiness, hallucinations, and hypercapnia

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Nursing care plans for meningitis
Nursing Care Plans for Meningitis

Desired Outcome

  • The patient will maintain cerebral tissue perfusion as evidenced by an increased level of consciousness (i.e., awake and alert) and will have an orientation with persons, places, and things.
Nursing InterventionsRationales
Assess the patient’s vital signs and neurological status at least every 4 hours or more frequently if there is a change in them.To assist in creating an accurate diagnosis and monitoring medical treatment effectiveness for meningitis.
Observe the patient for any signs and symptoms of increased ICP, such as sudden headache, vomiting, and decreased alertness.To facilitate early detection and management of increased ICP. Increased ICP can be life-threatening, leading to brain damage, stroke, or coma.
Administer the prescribed antibiotic medications.Use the antibiotic to treat bacterial meningitis, which is the underlying cause of the patient’s increased ICP.
Administer osmotic diuretics (e.g., Mannitol) as prescribed.To promote blood flow to the brain and to reduce cerebral edema.
Elevate the head of the bed at 30 degrees.To promote venous drainage from the patient’s head to the rest of the body in order to decrease ICP and reduce cerebral edema.

Nursing Care Plans for Meningitis – Care Plan 2: Diagnosis  Hyperthermia

Related to infective process of bacterial meningitis

Evidenced by a temperature of 38.5 degrees Celsius, rapid and shallow breathing, flushed skin, profuse sweating, and weak pulse.

Desired Outcome

  • Within 4 hours of nursing interventions, the patient will have a stabilized temperature within the normal range.
Nursing InterventionsRationales
Assess the patient’s vital signs at least every 4 hours.To assist in creating an accurate diagnosis and monitor the effectiveness of medical treatment, particularly the antibiotics and fever-reducing drugs (e.g., Paracetamol) administered.
Remove excessive clothing, blankets, and linens. Adjust the room temperature.To regulate the environment’s temperature and make it more comfortable for the patient.
Administer the prescribed antibiotic and antipyretic medications.Use the antibiotic to treat a bacterial infection, which is the underlying cause of the patient’s hyperthermia. Use the fever-reducing medication to stimulate the hypothalamus and normalize the body temperature.
Offer a tepid sponge bath.To facilitate the body in cooling down and to provide comfort.
Elevate the head of the bed.Head elevation helps improve the expansion of the lungs, enabling the patient to breathe more effectively.

Nursing Care Plans for Meningitis – Care Plan 3: Diagnosis  Acute Pain

Related to meningeal inflammation and elevated intracranial pressure secondary to meningitis

Evidenced by stiffness in the neck, migraine, anxiety, and nuchal tightness.

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Nursing care plans for meningitis
Nursing Care Plans for Meningitis

Desired Outcomes

  • The patient will verbalize comfort and pain reduction sensations.
  • The patient will also be able to manage other symptoms and complications of meningitis.
Nursing InterventionRationale
Examine the patient’s headaches and sensitivity to light.  Once the brain’s meninges become affected, it can induce swelling and severe headaches. Meningitis can also trigger photophobia. That is why this intervention is one of the most important ways to manage meningitis.  
Examine Kernig’s sign to test pain and resistance on passive knee extension with hips completely flexed and Brudzinski’s sign to assess hips flex on forwarding head bending.  These signs are used to look for any indications of meningeal inflammation.  
Keep the atmosphere calm and the patient’s room darker.  This intervention is beneficial since dimming the room will alleviate photophobia.
Minimize distractions and limit visitation.  Distractions can elevate intracranial pressure, exacerbating the symptoms.  
Control the surroundings to promote relaxation.    Increased noise and dazzling light in the surroundings produce sensory overload, which causes cerebral inflammation and leads to seizures.
Turn the patient’s position frequently and carefully.  This approach improves the patient’s relaxation while reducing irritability and tension.      
Motivate the patient to conduct Range of motion (ROM) exercises.  This intervention will prevent neck pain and joint stiffness.    
As directed, take the antibiotic and corticosteroids prescribed.    Antibiotics and corticosteroid therapy are prescribed to decrease inflammation and pain.
As recommended, administer analgesics such as acetaminophen or NSAIDs if the pain becomes intolerable.  This intervention must be considered since NSAIDs are used to manage pain.  

Nursing Care Plans for Meningitis – Care Plan 4: Diagnosis  Disturbed Sensory Perception

Related to a reduced level of consciousness, elevated intracranial pressure, cerebral inflammation, and hydrocephalus secondary to meningitis

Evidenced by the altered sensorium or nerve system.

Desired Outcomes

  • The patient will be able to maintain his or her typical level of consciousness.
  • The patient will also be knowledgeable about the symptoms of meningitis and will know how to combat these.
Nursing InterventionsRationale
Using the pediatric Glasgow coma scale, evaluate the patient’s level of consciousness.  The Glasgow coma scale is a dependable and accurate method of assessing the physical, cognitive, and sensory clues associated with the level of consciousness. Therefore, the level of damage in meningitis can be determined with the help of a neurological examination.  
Monitor and inform the doctor if the patient’s level of consciousness continues to deteriorate.    If consciousness levels begin to decline, additional or different treatment may be required. Changes in mentation, tremors, hypertension or high blood pressure, arrhythmia, or respiratory problems can suggest that intracranial pressure (ICP) rises due to decreasing cerebral perfusion pressure.
Examine for symptoms of cerebral edema such as vertigo, migraine, abnormal breathing, neck pain, nausea, and vomiting.    As the symptoms worsen, oxygen depletion, vasodilation, or vascular obstruction can cause cerebral edema due to elevated extracellular and intracellular fluid in the brain.
The patient’s ability to follow basic or comprehensive commands.    When one of the brain hemispheres is involved, cognitive performance suffers. That is why this intervention is necessary for evaluating the patient’s cognitive function.  
Examine the presence or absence of defensive responses such as swallowing, gagging, blinking, and coughing.    This approach determines the absence of reflexes which indicates late symptoms of rising intracranial pressure.
Examine the patient’s meningeal irritation symptoms such as headache, photophobia or sensitivity to light, nuchal tightness, opisthotonic posture, Kernig’s sign, and Brudzinki’s sign.    Meningeal symptoms are fundamental aspects of meningeal irritation caused by meningitis, spinal root inflammation, and the accumulation of infectious exudates.
Upraise the bed head to 30° to 45° while keeping the patient’s head in a normal position.    This technique promotes venous circulation from the brain and aids in the reduction of intracranial pressure.
As necessary, reorient the patient to the surroundings.    It is critical to practice coping techniques regularly to improve cognitive performance.
Assist the patient in the diagnosing procedures such as the following: VentriculogramCerebrospinal Fluid (CSF), lumbar punctureElectroencephalogramMagnetic Resonance Imaging (MRI), Computed Tomography (CT Scan) The following diagnostic tests are performed to determine intracranial pressure and the prevalence of harmful microorganisms.  
Commence seizure prevention by observing and caring for the patient during the episode.    Providing adequate and exact care minimizes complications and further brain injury during a seizure.
Retain the atmosphere calm and the lighting dark.    This technique inhibits stimuli that could trigger or exacerbate a convulsion attack.
Throughout the first 24 hours, measure pupil size every 3 hours, then every 6 hours.    Increased intracranial pressure (ICP) causes irregular pupil diameters and a static enlarged pupil.    
Monitor and report the patient’s seizure frequency and severity. Inform also the doctor if the patient is having seizures.  Variations in seizure patterns indicate the necessity for additional neurological testing, anti-seizure drugs, and therapy reassessment. Seizures typically occur antecedent to a rise in intracranial pressure (ICP). Appropriate infection treatment will prevent subsequent worsening and keep intracranial pressure within normal ranges.
Encourage parents to be involved in their patient’s care.    This method assists in better coping and anxiety reduction.
Administer and evaluate anticonvulsant medication dosages. .  Anticonvulsants are used for both management and cure. Therapy entails maintaining therapeutic serum concentrations to avoid convulsions.

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Nursing care plans for meningitis
Nursing Care Plans for Meningitis

Nursing Care Plans for Meningitis – Care Plan 5: Diagnosis  Risk for Injury

Related to modified neurological regulatory function, disorientation, and restlessness secondary to meningitis.

Risk for injury is not correlated with any signs and symptoms because it has not yet developed in the patient, and safety precautions will be undertaken instead.

Desired Outcome

  • The patient will be knowledgeable enough on avoiding injury and how to manage it if it occurs unexpectedly.
Nursing Interventions Rationale
Assess neurologic condition, including VS pattern, awareness changes, behavior patterns, and pupillary or ocular responses suitable for age. Furthermore, if the patient is an infant, measure head circumference.  This method provides information that may indicate an elevation in intracranial pressure produced by brain inflammation and accompanying edema.  
Integrate a cardiac and respiratory monitor to detect arrhythmia and oxygen depletion.Elevated intracranial pressure causes a decline in heartbeat and respiration and widening pulse pressure, with pulse becoming erratic and respiratory rate becoming quick and shallow as ICP rises and the body seeks to reduce blood supply to the brain.  
Observe any seizure activity, including the onset, recurrence, length, and movements before, during, and after the seizure. Moreover, pad the bed and eliminate any objects or toys from the bed, and provide any anticonvulsants that have been prescribed.  This intervention protects the patient from damage during a seizure, which is a consequence of meningitis.  
Allow for rest periods between care or procedures, offer an excellent serene atmosphere devoid of bright lighting, limit visiting if irritated, and decrease gentle handling and care of the patient.    This method reduces irritation and improves comfort and repose.
Stay close to the patient and speak in a low voice.    During the acute period of the condition, it provides limited stimulation to the patient.
Maintain head alignment with a sandbag while elevating the head up to 30 degrees.  This technique reduces intracranial pressure by enabling blood to circulate from the brain via gravity or any impediment to venous outflow.  
Reposition the patient every 2 hours to maximize convenience with the head of the bed (HOB) slightly raised, no pillow in bed, and place him or her in a side-lying position if nuchal rigidity is prevalent; avoid jerky movements such as trying to lift the head. Lastly, have oxygen and suctioning equipment ready to be utilized when considered necessary.  This approach improves airway patency and prevents discharge from obstructing it, which increases carbon dioxide retention and intracranial pressure.  
Discuss to the patient the causes of increasing ICP and prevent further elevations.  This method allows for a better understanding of the high ICP and the potentially severe nature of such a disorder.
Notify the parents of any changes in their patient’s condition, the reasons for physiological and mental changes, and the repercussions of the disease.    This method enhances understanding of the disease’s potential manifestations and consequences.
Notify the patient of the cause of the epileptic seizures and other indications and symptoms of the disease and the treatment required.      This method teaches seizure consequences and measures and responsibility in preventing or treating this activity.
Communicate with parents about the danger of problems and the necessity for strict intracranial pressure monitoring. Therefore, go over the signs and symptoms of high intracranial pressure.    This strategy provides for continuing care and responsibility in minimizing neurological state changes.
As soon as antibiotics are prescribed, take them as directed based on cerebrospinal fluid (CSF) analyses and throat cultures.    This technique controls current infections and actually prevents infections from spreading; this is the exact mechanism by which antibiotics work against meningitis.
Use stool softeners, avoid restraints, and avoid or minimize crying outbursts.    This method prevents the Valsalva maneuver, which raises intracranial pressure.
Orient the patient to his or her environment and reorient as needed. Place a call bell within reach and educate how to use it. Make sure to respond to the call quickly. To avoid accidents, the patient must become accustomed to the arrangement of the surroundings. Items that are too far away from the patient may pose a risk.

Related FAQs

1. What are 5 symptoms of meningitis?


  • Sudden high fever.
  • Stiff neck.
  • Severe headache that seems different from normal.
  • Headache with nausea or vomiting.
  • Confusion or difficulty concentrating.
  • Seizures.
  • Sleepiness or difficulty waking.
  • Sensitivity to light.

2. Can a person survive meningitis?

Bacterial meningitis is serious. Some people with the infection die and death can occur in as little as a few hours. However, most people recover from bacterial meningitis. Those who do recover can have permanent disabilities, such as brain damage, hearing loss, and learning disabilities.

3. How do I know if I’ve got meningitis?

The first symptoms are usually fever, vomiting, headache and feeling unwell. Limb pain, pale skin, and cold hands and feet often appear earlier than the rash, neck stiffness, dislike of bright lights and confusion.

4. What are the 3 types of meningitis?

There are a few different types of meningitis, including viral, bacterial, and fungal meningitis.

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