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학습 자료 둘러보기 →In an immunocompromised patient, the combination of a temperature of 102.8°F (39.3°C) and altered mental status is a critical red flag for meningitis or meningoencephalitis. Classic signs like nuchal rigidity may be absent, making a change in consciousness the primary indicator of CNS involvement.
Immediate nursing actions include notifying the provider, preparing for a lumbar puncture and blood cultures, and initiating seizure and airway precautions. Do not delay care while waiting for a CD4 count, as this is not an acute emergency indicator.
Do not attribute altered mental status solely to fever or systemic illness. In an immunosuppressed patient, it must be assumed to be a life-threatening CNS infection until proven otherwise, requiring emergent evaluation and broad-spectrum antimicrobial coverage.
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