Nursing Management
Priority Interventions
- Airway protection - Monitor for decreased level of consciousness and impaired gag reflex
- Neurological assessments every 15-30 minutes initially, including Glasgow Coma Scale
- Seizure precautions with padded side rails and suction equipment readily available
- Monitor for signs of increased intracranial pressure (ICP)
- Antiviral therapy: Acyclovir 10mg/kg IV every 8 hours for 14-21 days for suspected HSV encephalitis.
- Supportive care includes fever management, fluid balance monitoring, and prevention of complications.
Critical Alert: Start acyclovir immediately when HSV encephalitis is suspected - do not wait for confirmation
Key Points
- Early antiviral treatment significantly improves outcomes in HSV encephalitis
- Maintain seizure precautions throughout hospitalization
Commonly Confused Concepts
| Feature |
Encephalitis |
Meningitis |
| Primary symptom |
Altered mental status |
Neck stiffness |
| Brain involvement |
Brain parenchyma |
Meninges only |
| Seizures |
Common (50-60%) |
Less common (20-30%) |
| Focal deficits |
Frequent |
Rare |
Memory Aid
"ENCEPH-BRAIN" - Encephalitis affects the BRAIN tissue, causing altered mental status
"MENING-NECK" - Meningitis affects meninges, causing NECK stiffness
Study Tips & Quick Checks
NCLEX Success Strategies
- Remember the "3 A's": Airway, Acyclovir, Assessments (neurological)
- Focus on temporal lobe involvement in HSV encephalitis questions
- Prioritize interventions: ABC's first, then neurological monitoring
Quick Recognition
If you see: Fever + Headache + Confusion + Seizures = Think ENCEPHALITIS
Common Pitfall: Don't confuse encephalitis with meningitis - altered mental status is the key differentiator
Self-Assessment Checklist
- ☐ Can I differentiate encephalitis from meningitis?
- ☐ Do I know the priority nursing interventions?
- ☐ Can I identify HSV encephalitis characteristics?
- ☐ Do I understand when to start acyclovir?