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# Nursing Diagnosis * Ineffective Tissue Perfusion (cerebral) related to infectious process and cerebral edema * Hyperthermia related to the infectious process and cerebral edema * Risk for imbalanced Fluid Volume related to fever and decreased intake * Acute Pain related to meningeal irritation *...

# Nursing Diagnosis * Ineffective Tissue Perfusion (cerebral) related to infectious process and cerebral edema * Hyperthermia related to the infectious process and cerebral edema * Risk for imbalanced Fluid Volume related to fever and decreased intake * Acute Pain related to meningeal irritation * Impaired Physical Mobility related to prolonged bed rest # Nursing Management ## Enhancing Cerebral Perfusion * Assess LOC, vital signs, and neurologic parameters frequently. * Observe for signs and symptoms of ICP (e.g., decreased LOC, dilated pupils, widening pulse pressure). * Maintain a quiet, calm environment to prevent agitation, which may cause an increased ICP. * Prepare patient for a lumbar puncture for CSF evaluation, and repeat spinal tap, if indicated. Lumbar puncture typically precedes neuroimaging * Notify the health care provider of signs of deterioration: increasing temperature, decreasing LOC, seizure activity, or altered respirations. * I/V mannitol is administered. # Nursing Management ## Reducing Fever * Administer antimicrobial agents on time to maintain optimal blood levels. * Monitor temperature frequently or continuously. * Institute other cooling measures, such as a hypothermia blanket, as indicated. * Administer antipyretics as ordered like paracetamol. # Nursing Management ## Maintaining Fluid Balance * Prevent I.V. fluid overload, which may worsen cerebral edema. * Monitor intake and output closely. * Monitor CVP frequently.