Medical Management
Trealment of choice is cephalosporin which is given interavenously, alternatively can be given. In case of increased intra cranial pressure mannitol and other ampicillin diuretics are given. Corticosteriods and other supportive therapy is given including anticonvulsant therapy.
Nursing Assessment
The typical symptoms are rarely seen in the child under two years of age, you need to bc alert to the reports by parents that the child is not feeding well, is vomiting and has diarrhoea and also the infant is lethargic, sleepy and the cry is weak. The symptoms mainly include sudden onset with high fever, vomiting, restlessness, irritability, headache and often convulsions.
In new bornsismall infants, pyogenic meningitis may have insidious onset with symptoms like refusal to take feed, fever and irritability and some may have convulsions also. The bulging anterior fontanel is a late sign. The neonates's neck usually remains supple. In older children the physical examination may reveal typical meningeal signs like headache, neck rigidity (nuchal rigidity) positive kerning's and brudzsinki's sign. Cranial nerve palsies and papilloedema are present in some cases. In some cases hemiplegia may also be present.
The nurse needs to observe the child for irritability, photophobia, drowsiness, stupor and coma. The parents may report seizure activity, fever, chills, vomiting and change in sensorium.