ATI Unit 2 Meningitis

Question 1

what is meningitis?

Answer 1

• an infection of the meninges, the protective layers surrounding the brains; most are viral (or asceptic) and resolve on their own; fungal happens in AIDs patients
• bacterial is the most dangerous and their are 3 strains of meningitis vaccines. one specifically for college dorm students (think overcrowded, comorbidity, infection of lungs ENT)
  Note: use insect repellant when risk of being bit by mosquito exists

Question 2

what are the three meningitis vaccines?

Answer 2

1) Haemophilus influenza type B (Hib) vaccine - infants, should be on schedule
2) Pneumococcal polysaccharide vaccine (PPSV) - immunocompromised, chronic disease, older, smokers, in long-term care
3) Meningococcal vaccine (MCV4) - Neiseria meningitis usually for college, military, etc

Question 3

what is the vaccine against viral meningitis?

Answer 3

there is none, includes mumps, measles, herpes, and arboviruses (West Nile)

Question 4

symptoms of meningitis?

Answer 4

• headaches
• altered mental states
• infection stuff
• positive Kernig’s (resistance/pain with extension of leg from flexion) and Brudzinski’s Sign (flexion of extremities with deliberate flexion of neck)
• red, macular rash
• seizures

Question 5

what’s the most definitive test for meningitis?

Answer 5

CSF analysis post-lumbar puncture
- analysis includes
Color of CSF 
1. cloudy (bacterial)
2. clear (viral)
3. decreased glucose (bacterial)
4. elevated WBC and protein and CSF pressure

Question 6

what precautions are a patient with menigiitis under?

Answer 6

droplet + standards

- keep until antibiotics have at least been started for 24 hours

Question 7

care for patient with meningitis

Answer 7

1) cool blanket
2) decrease stimuli
3) raise bed (ICP) - avoid coughing/sneezing
4) provide emesis basin b/c of NV
5) monitor for tachycardia

Question 8

if the ICP increased in a patient with meningitis, what could you anticipate giving and why?

Answer 8

anticonvulsant like dilantin (phenytoin) b/c of seizures

Question 9

ceftriaxone (Rocephin) or cefotaxime (Claforan) in combo with vanocin (Vancomycin).
and
ciprofloxacin (Cipro), rifampin (Rifadin), or ceftriaxone (Rocephin)
— what are these different sets for in relation for meningitis

Answer 9

• combo with vanco = treatment

- cipro, rifampin etc = prophylactic

Question 10

Complications of meningitis

Answer 10

1) Increased ICP and poss herniation
- signs: decreased LoC, pupillary changes, impaired ocular movements, hypertension
- positioning and avoid coughing/sneezing
- admin mannitol IV

2) SIADH (diluted blood, hypokalemia, hypocalcemia, hypernatremia, concentrated urine)
- admin demeclocycline

3) Septic emboli
- can cause gangrene

Question 11

when would you administer dexamethasone (Decadron) in a patient with meningitis?

Answer 11

• before the first round of antibiotics, it’s a corticosteroid