A child recovers from meningitis. The nurse knows that which complication may be seen in this child in the fu… - AIIMS Rishikesh NO - 2019

AIIMS Rishikesh NO - 2019

Child Health Nursing (Pediatrics)

Hard

Appeared in: AIIMS Rishikesh NO - 2019

Explanation

Meningitis, the inflammation of the meninges, can cause tissue scarring and adhesions as it heals.
This scarring can obstruct the narrow pathways for cerebrospinal fluid (CSF) circulation or impair its absorption by the arachnoid villi.
The blockage leads to an accumulation of CSF within the brain's ventricles, a condition known as hydrocephalus.
This fluid buildup increases intracranial pressure, which can cause further brain damage if not treated.

Option B: Encephalitis is the inflammation of the brain tissue itself. While it can occur with meningitis (a condition called meningoencephalitis), it is not considered a future complication that develops after the initial infection has resolved.
Option C: Mental retardation (intellectual disability) is a potential severe outcome or sequela of meningitis, but it is the result of brain damage. Hydrocephalus is a more direct, primary complication that can cause this damage if left untreated.
Option D: Failure to thrive is a general term for inadequate physical growth. While a child may experience this after any severe illness due to poor appetite or metabolic stress, it is not a specific neurological complication of meningitis.

Clinical Relevance

Nursing practice connection: Use the key finding related to Long-term complications of pediatric meningitis to guide bedside assessment, documentation, and the next nursing action.
Nurses are vital for the early detection of hydrocephalus post-meningitis by performing serial head circumference measurements in infants and assessing for signs of increased intracranial pressure (ICP) like a bulging fontanel, vomiting, and irritability.
Prompt reporting of these signs is critical as early surgical intervention (e.g., ventriculoperitoneal shunt) can prevent permanent brain damage and developmental disabilities.
What if? If the patient was an adult, hydrocephalus would not cause an enlarging head circumference. Instead, the nurse would monitor for the triad of symptoms associated with normal pressure hydrocephalus: gait disturbance, cognitive decline/dementia, and urinary incontinence.

How to Approach the Question

First, identify the key elements of the question: a child who has recovered from meningitis and a potential 'future' complication.
Recall the basic pathophysiology of meningitis: it is an inflammation of the meninges.
Think about the consequences of inflammation and healing in a closed space like the cranium. Healing often involves scarring.
Consider how scarring of the membranes surrounding the brain could affect fluid dynamics. The cerebrospinal fluid (CSF) circulates in this space.
Evaluate the options: Hydrocephalus is a direct mechanical result of blocked CSF flow. Encephalitis is a different (though related) disease process. Mental retardation is a potential functional outcome of damage, not the primary complication itself. Failure to thrive is a non-specific systemic issue.
Conclude that hydrocephalus is the most direct and specific complication resulting from the pathophysiology of meningitis.

Concept Tested & Keywords

Concept Tested: Long-term complications of pediatric meningitis
Stem keywords: child, recovers, meningitis, complication, future
Lead-in keywords: which complication
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

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E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 2 (pp 239-476 of 713) pp. 218-220, 216-218