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# Diagnostics - Computed tomography (CT) scan or magnetic resonance imaging (MRI) scan to detect a shift in brain contents prior to a lumbar puncture. - Key diagnostic tests: - bacterial culture and Gram staining of CSF and blood - WBC's are elevated at 30,000/mm3 and her neutrophils are 25,000...

# Diagnostics - Computed tomography (CT) scan or magnetic resonance imaging (MRI) scan to detect a shift in brain contents prior to a lumbar puncture. - Key diagnostic tests: - bacterial culture and Gram staining of CSF and blood - WBC's are elevated at 30,000/mm3 and her neutrophils are 25,000/mm3. Her Cerebrospinal fluid was turbid and cloudy and positive for glucose and protein. # Pharmacological Management - Antibiotics - Vancomycin hydrochloride in combination with one of the cephalosporins (eg, ceftriaxone sodium, cefotaxime sodium), penicillins intravenous (IV) injection. - Dexamethasone (Decadron) - Corticosteroid - Dehydration and shock are treated with fluid volume expanders. - Seizures, are controlled with phenytoin (Dilantin). - Increased ICP is treated as necessary - Mannitol - Antviral - Tenonofir - Antifungal - Fluconazole - Antipyretics- Acetaminophen # 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