CHP 69 Flashcards by Tiffany Flournoy

Meningitis Types & DX &LABS

inflammation of the meninges fluid space around the brain
Fungal - AIDS
Bacterial: otitis media, sinusitis,
Aseptic: viral infection- cancer or immunosuppressant
N. meningitis: VACCINE INTIAL DOSE 11TO 12 Aerosol secretions (AIRBIRORNE) dorms, jails, prison.
LABS: urine throat nose culture blood and sensitivity test
CSF- MOST DEFINITE DIAGNOSTIC TEST (lumbar puncture)
CSF - clear(viral) cloudy(bacterial) ELEVATED PROTEIN , DECREASED GLUCOSE, ELEVATED WBC ELEVATED CSF

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Meningitis: SYMPTOMS

headache, nuchal rigidity(stiff neck), photophobia(sensitibity to light), irritable , Kernigs sign, (positive Brudzinski hyperactive deep tendon reflexes TACYCARDIC

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Meningitis: TREATMENTS

Vaccine:11-12 BOOSTER @ 16 before they start middle school and then booster and then before go to
Dexamethasone
Antibiotic (bacteria)

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Meningitis: INTERVENTIONS

ISOLATE , DROPLET  STANDARD PRECAUTIONS INDICTATED FOR ALL CLIENTS WITH MENIGITIS  (ATI pg 32)
HOB 30 degress 
AVOID COUGHING SNEEZING 
watch vitals and LOC 
control pain and fever
Protect from injury(seizure preauction)
get daily weights(measure I&amp;O, specific gravity) 
Turn keep dry 
Infection control 
Negative  pressure (AIRBORNE)
keep door closed 
Keep lights  off 
Keep environment calm

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Kerning Sign

flexing knee up toward chest increase pressure in brain and have pain and not fully extended because of pressure

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Brudzinski Sign

bend neck slightly and causes pain

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Brain Abscess

Cause: otitis media, rhionsinutis ( nose open to the brain) - infection in the brain

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Brain Abscess: SYMPTOMS

headache worst in the morning, fever, neuro deficiency, ICP- vomiting

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Brain Abscess: TREATMENT

MRI
Burr Hole( go in aspirate)

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Brain Abscess: MEDICAL MANAGMENT

Control ICP
steroids- tx cerebral edema
Antibiotics
Frequent Neuro assessments

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Encephalitis

acute inflammatory process of brain tissue

Viral infections: Herpes simplex vector borne infections and or fungal infection

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Encephalitis: SYMPTOMS

Headaches change in LOC hallucinations , rashes flaccid paralysis (maintain skin) Parkinson like movements

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Encephalitis: TREATMENT

acyclovir for HSV amphotericin and other antifungal

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Creutzfeldt- Jakob Disease

TAINTED BEEF-doesn’t respond sterilization smaller than virus little organism (transmissible spongiform encephalopathies)
s/s: sensory motor or cognitive deficients

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Creutzfeldt- Jakob Disease : NURSING MANAGMENT

CONTACT PRECAUTIONS blood and body precautions

will not get better

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Multiple Sclerosis

CNS progressive’s demyelination of CNS RELASPING AND REMITTING
s/s: weakness numbness fatiue BALANCE AND ACITIVTIY INTOLERANCE pain , lack of visual fields visual disturbances (PRONE TO FALLS)
Medical Management: Interferon , steroids , works on muscle spasms fatigue ataxia Bowel and Bladder Issues

Myasthenia Gravis

HEAD DOWN effects junction b/w the site of the muscle nerve junction antibodies to acetylcholine RECEPTOR IS AM ISSUE
s/s: starts at top woks down will see the muscle in the eyes (Dipolopia adn Pitotis ) generalized weakness (eating is a hard thing to do) medication will be given during meal time smal meals liquid meal (boost)
dysphonia- swalloing and voive impairment

Myasthenia Gravis : MEDICAL MANAGMENT

modify diet anything to reduce antibodies - immunosuppressants therapy 
IVIG plasma (take blood out give back RBC)  replace with donor plasma (good antibodies)

Myasthenic Crisis

disease exacerbation have hard coughing clearing secretions (TOP DOWN)

Cholinergic Crisis

severe weakness respiratory failure
MANAGMENT: intubate them on ventalator . electrytoles , NG TUBE
AVOID SEATIVES AND TRANQUILIZERS

Myasthenia Gravis: NURSING INTERVENTIONS

pt on activity and REST , DAILY EXCERISE (build muscles during exacerbations ) AVOID strenuous activity
bowl and bladder control , KEEP ROUTINE, KEEP STRESS DOWN , NO EXTREME TEMPS, THICKENED LIQUIDS , LIST NUMBERS FOR MEMORY AIDS

Gullain Barre syndrome :

FEET DOWN-autoimmune acute attacks on peripheral nerve myelin
paryasis of diaphragm we are not breathing respiratory failure
VIRAL INFECTION

Gullian Barre Syndrome : SYMPTOMS and GOALS

paralysis weakness parenthess pain diminished or ABSENT RELEX
goals: intubate and ventilate get up moving if not paralyzed

Gullian Barre Syndrome: MEDICAL MANAGEMENT + NURSING MANAMGMENT

medical management: medical emergency respirtory support
Nursing management: enhance mobility PASSIVE RANGE OF MOTION position changes watch Swalloing and gag reflex MAY NEED COMMUNCATION BOARD

Gullian Barre Syndrome: Complications and Diagnosis

Respiratory failure autonomic dysfunctionn pulse breathing DVT pulmonary embolism urinary rentention Diagnosis : breathing patterns and gas exchaneg

Trigeminal Neuralgia

fifth cranial nerve , common second and third branches of NERVE COMPRESSION and pressure is probable cause along VASCULAR PORTION

Trigeminal Neuralgia: SYMPTOMS

PAIN (burning and throbbing) washing face brushing hair bruising teeth draft from air they avoid eating and neglect hygiene and sometimes isolate themselves

Trigeminal Neuralgia: MEDICAL MANAGMENT and NURSING MEDICATION

ant seizure medication (carbamazepine) PAIN MANAGMENT take meds before you do your ADL STAY AWAY FROM FOODS VERY HOT OR COLD chew on unaffected side , insomnia

BELLS PALSY

facial paralysis unilateral inflammation senth crainal nerve S/s: unilateral, muscle weakness facial distortion increased lacrimation drooly, some painful sensation eye irritation difficulty speech eating can last days to weeks

BELLS PALSY: MANAGMENT

STEROIDS reduce inflammation and diminsh severity of the disorder Protect eye from injury cover eye with sheild close eye lid use eye ointment and sunglasses facial exercises and massages to maintain muscle tone

MENIGITIS: COMPLICATIONS

INCREASED ICP - HOB 30 degress Mannitol given IV SIADH (concentrated blood)- monitor weight daily SEPTIC EMBOLI