Case Study, Chapter 25, Assessing Neurologic System

A nurse is caring for a 48-year-old man diagnosed with meningitis after a head injury.

The client was driving a motorcycle while on vacation and was not wearing a helmet. It

had started to rain, and the client’s motorcycle swirled onto a grassy area. He fell off the

motorcycle and landed on the ground. The client hit his head and suffered cuts and

abrasions to his face, arms, and legs from the fall. He was taken to the emergency

department of the local hospital by paramedics. Upon examination, the physician ordered

a head CT scan and a brain MRI to determine if any head trauma had occurred. Both

exams revealed negative findings, and the client was sent home after a 24-hour stay at the

hospital for observation. The client was to return in 1 week for follow-up unless

symptoms developed. Three days after the accident, the client began to have severe

headaches, nausea and vomiting, blurred vision, and an oral temperature of 103°F

(39.4°C). The client returned to the emergency department, and a diagnosis of meningitis

was confirmed. The client was admitted and started on IV antibiotics. The next morning,

the client asks the nurse “What is going on? I left the hospital 3 days ago and I felt fine.”

(Learning Objectives: 1, 3)

Questions:

a. How should the nurse respond to the client’s question?

b. The nurse needs to complete the admission forms. When collecting subjective data, on
what present or past health concerns should the nurse focus?