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What is meningitis?
- An infection of the meninges-the covering of the brain and spinal cord
- Can be bacterial, viral, parasitical
- Infectious disease
- Basillar skull fx
- Otitis media
- Neurosurgery-invasive procedures
- Systemic sepsis
- Impaired immune function
Etiology & patho.
- Infection of meninges & CSF
- Infection causes inflammatory response in meninges
- Results in meningeal congestion, cerebral edema, increased ICP
Types of meningitis?
- Most common
- Can cause brain damage, hearing loss, learning disabilities- even when treated quickly
- MEDICAL EMERGENCYDeath can occur within 48 hrs even if treated
- Confusion, altered LOC
- Restlessness, agitation, irritability
- Abd & back pain
- Severe headaches
- + Brudzinski's
- + Kernig's
- Stiff neck-nuchal rigidity
- Fever & chills
- S/S increasing ICP
What is Kernigs sign?
Pain and/or resistance occurs c flexion of the knee and hip and straightening of the knee in the supine position
What is Brudzinskis sign?
Pain, resistance & hip & knee flexion occur when neck is flexed to the chest while lying supine
What is Opisthotonos?
- A titanic spasm where head and heels are bent backward and body is bowed forward
- In severe cases of meningitis.
Manifestations of ICP.
- Most significant: change of LOC
- Earliest: blurred vision, decreased visual acuity, diplopia
- Next: headache, papilledema (swelling of optic disc), vomiting
Planning & imlementation
- Assess neuro status/VS regularly
- Assess changes in neuro status, presence of cranial nerve dysfunction
- Assess/prepare for seizures
- Assess for increased ICP
- Admin meds/maintain fluid restrictions
- Assess for fluid volume deficits
- Monitor I&O, DW, skin turgor, labs, urine concentration
Diagnostic tests for meningitis.
- Culture of CSF ID's causative organism
- Culture of blood, urine, nose, throat
- CT scan of head
- Chest/Sinus x-ray
- Increase WBC
- High dose, broad spectrum antibiotics initially
- IV replacement
Patient teaching for meningitis.
- Prophylactic antibiotic therapy for close contacts
- Vaccinations for pediatric
- S/S to look for
- Management of present illness