What is the nursing care for tuberculous meningitis?

Generally, tuberculous meningitis is a central nervous system infection caused by Mycobacterium tuberculosis invading the meninges. Nursing care includes condition monitoring, position management, nutritional support, medication management, and psychological counseling, aiming to assist in controlling the disease and promoting physical recovery. The details are as follows:

1. Condition Monitoring: It is necessary to closely observe the patient's level of consciousness, body temperature, pulse, respiration, blood pressure, and other vital signs, as well as whether symptoms such as worsening headache, vomiting, or convulsions occur. If there is increased confusion, persistent high fever, or frequent convulsions, timely documentation and reporting are required.

2. Position Management: During bed rest, the head of the bed can be elevated 15°-30° to reduce intracranial pressure and alleviate discomfort such as headache and vomiting. The patient should be assisted to turn over regularly, every 2-3 hours. Movements should be gentle during turning, avoiding pressure on the head. The bedsheet should be kept flat and dry to prevent pressure ulcers.

3. Nutritional Support: Based on the patient's digestive capacity, provide high-calorie, high-protein, easily digestible foods such as steamed egg, lean meat porridge, and vegetable puree to ensure adequate nutrient intake. If the patient has difficulty swallowing, enteral feeding via a nasal tube can be used. The speed and temperature of feeding should be controlled to prevent coughing or bloating.

4. Medication Management: Strictly follow medical instructions to ensure the patient takes anti-tuberculosis medications on time and in the correct dosage; do not adjust the dosage or discontinue medication without authorization. Monitor for adverse reactions such as nausea, vomiting, or rash during medication use, record the timing and severity of reactions, and communicate promptly with healthcare providers to ensure safe and effective drug use.

5. Psychological Counseling: Due to the severity of the illness and prolonged bed rest, patients may easily develop anxiety or irritability. Nursing staff should communicate frequently with the patient, listen patiently to their concerns, and provide encouragement and comfort using gentle language to help build confidence in treatment.

It is recommended to keep the ward quiet and clean during nursing, control indoor temperature and humidity appropriately, and regularly open windows for ventilation. Additionally, assist patients in performing appropriate limb exercises, such as massaging limb muscles, to prevent muscle atrophy.