(7) Opisthotonos (extreme hyperextension of the head and arching of the
back due to irritation of the meninges).
Altered level of consciousness.
Multiple petechiae on the body.
e. Nursing Management.
Administer intravenous fluids and medications, as ordered by the
(a) Antibiotics should be started immediately.
(b) Corticostertoids may be used for the critically ill patient.
(c) Drug therapy may be continued after the acute phase of the illness
is over to prevent recurrence.
(d) Record intake and output carefully and observe patient closely for
signs of dehydration due to insensible fluid loss.
Monitor patient's vital signs and neurological status and record.
(a) Level of consciousness. Utilize GCS for accuracy and consistency.
(b) Monitor rectal temperature at least every 4 hours and, if elevated,
provide for cooling measures such as a cooling mattress, cooling sponge baths, and
administration of ordered antipyretics.
(3) If isolation measures are required, inform family members and ensure
staff compliance of isolation procedures in accordance with (IAW) standard operating
Provide basic patient care needs.
(a) The patient's level of consciousness will dictate whether the patient
requires only assistance with activities of daily living or total care. If patient is not fully
conscious, follow the guidelines for care of the unconscious patient (Section IV).
(b) Maintain dim lighting in the patient's room to reduce photophobic