I think headache is probably the lowest priority. It's a symptom. You have to address pain, but blood pressure and circulation is far more important. Pts with meningitis can become septic, and that triumphs over a headache. Urine output is important in meningitis because septic pt are at risk for renal failure. Puncture site is also important, but it depends if it is talking about assessing the site for bleeding. If LP sites bleed or leak, that can cause pressure changes in your CSF. Since there is no obstruction, headache is the last priority.