meningitis

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Author:
nurse&dad
ID:
106274
Filename:
meningitis
Updated:
2011-10-06 13:43:22
Tags:
neuro muscularskeletal
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interventions
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  1. What is meningitis?
    • An infection of the meninges-the covering of the brain and spinal cord
    • Can be bacterial, viral, parasitical
  2. Risk factors
    • Infectious disease
    • Basillar skull fx
    • Otitis media
    • Sinusitis
    • Mastoiditis
    • Neurosurgery-invasive procedures
    • Systemic sepsis
    • Impaired immune function
  3. Etiology & patho.
    • Infection of meninges & CSF
    • Infection causes inflammatory response in meninges
    • Results in meningeal congestion, cerebral edema, increased ICP
  4. Types of meningitis?
    • Bacterial
    • Aseptic
    • Fungal
    • Viral
  5. Bacterial meningitis
    • Most common
    • Can cause brain damage, hearing loss, learning disabilities- even when treated quickly
    • MEDICAL EMERGENCY
    • Death can occur within 48 hrs even if treated
  6. Clinical manifestaions
    • Confusion, altered LOC
    • Restlessness, agitation, irritability
    • Abd & back pain
    • N/V
    • Severe headaches
    • + Brudzinski's
    • + Kernig's
    • Photophobia
    • Stiff neck-nuchal rigidity
    • Fever & chills
    • Seizures
    • S/S increasing ICP
  7. 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
  8. What is Brudzinskis sign?
    Pain, resistance & hip & knee flexion occur when neck is flexed to the chest while lying supine
  9. What is Opisthotonos?
    • A titanic spasm where head and heels are bent backward and body is bowed forward
    • In severe cases of meningitis.
  10. Manifestations of ICP.
    • Most significant: change of LOC
    • Earliest: blurred vision, decreased visual acuity, diplopia
    • Next: headache, papilledema (swelling of optic disc), vomiting
  11. 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
  12. 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
  13. Medication therapy
    • High dose, broad spectrum antibiotics initially
    • Anticonvulsants
    • Antipyretic
    • Antiemetic
    • Analgesics
    • IV replacement
  14. Patient teaching for meningitis.
    • Prophylactic antibiotic therapy for close contacts
    • Vaccinations for pediatric
    • S/S to look for
    • Management of present illness

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