Bacterial Meningitis

Question 1

Bacterial Meningitis

Answer 1

• Bacteria reaches the meninges via the bloodstream from a nearby infection
  > or if an open wound like a neuro procedure
• Infections grow easily in CSP
• Incrd ICP S/S

Question 2

What will infected CSF look like

Answer 2

• Incr in WBC & protein
• Dcr in sugar
• We now also have bacteria in CSF
  CSF is made of sugar water; infected CSF is thick & acidic

Question 3

Bacterial Meningitis - Most Commonly Caused by

Answer 3

• Neisseria meningitidis (Meningococcal)
• Streptococcus pneumoniae (pneumococcal)
• Haemophilus influenzae (Hib)
  1st 3 have vaccine available
• Escherichia coli
  > from mom’s poop

Question 4

Bacterial Meningitis - Common CMs

Answer 4

• Headache
• Neck pain/stiffness
• Fever
• Lethargic
• Photophobia

Question 5

Bacterial Meningitis - Infant S/S

Answer 5

• Fever, cold hands & feet
• Fretful, dislike being handled
• Rapid breathing or grunting
• Unusual cry, moaning
• Stiff neck, dislike bright lights
• Refusing food & vomiting
• Drowsy, floppy, unresponsive
• Pale, blotchy skin, spots/rash
  > See Glass Test
• Tense, bulging fontanelle
• Convulsions/seizures

Question 6

Bacterial Meningitis - Child S/S

Answer 6

• Fever, cold hands & feet
• Drowsy, difficult to wake
• Severe muscle pain
• Severe headache
• Dislike bright lights
• Vomiting
• COnfusion & irritability
• Peal, blotchy skin, spots/rash
  > See Glass Test
• Stiff neck
• Convulsions/seizures

Question 7

Kernig’s Sign

Answer 7

Resistance to extensions of the leg while hip is flexed
knee is at 90 degree angle then pulled foward, pain w/ straightening leg

Question 8

Brudzinski’s Sign

Answer 8

Flexion of the hips & knees in response to neck flexion
knees pull towards chest when neck is flexed foward

Question 9

Bacterial Meningitis - Diagnosis

Answer 9

• Blood cultures
• CBC
• Lumbar puncture
  > definitive diagnostic
  > don’t start antibiotics until LP reveals meningitis so results are not altered

Question 10

Bacterial Meningitis - Nursing Interventions

Answer 10

• Droplet & seizure precautions
• Monitor
• Head circumference
  > infants
  > indication of ICP
• Envir’t
  > calm, lights off
• Comfort measures
• Safety

Question 11

Bacterial Meningitis - Medications

Answer 11

• Steroid
• Antibiotics
• Analgesics

Question 12

Bacterial Meningitis - Complications

Answer 12

• Hearing loss
• Neurologic deficit
• Seizures
  > seizure precautions
• Visual impairments
• Behavioral problems

Question 13

What is the Best Way to Prevent Bacterial Meningitis?

Answer 13

Vaccination