CNS Infections Flashcards
What is bacterial meningitis?
Bacterial infection of meningeal tissues.
What is the most common bacteria associated with bacterial meingitis?
N. meningitis
What are the signs and symtpoms of bacterial meningitis?
- Fever
- Severe HA
- N/V
- Nuchal rigidity
- Photophobia
- Decreased LOC
- Seizures
- Petechia that do not fade when pressed (meningococcal meningitis)
What are the TNIs for bacterial meningitis?
- Isolation as soon as bacterial meningitis is suspected.
- Vaccinations (fly/meningitis), prophylactic antibiotics if exposed to bacterial meningitis
- Assess VS, LOC/neuro, I/O, lung sounds, skin. Measures to reduce ICP
- Codeine for pain; prevent injury; HOB slightly elevated
- Assess for dehydration and adequate fluid intake; maintain nutritional intake
- Darkened room, cool cloth is the patient has photophobia
- Low lighting to decrease hallucinations if patient is delirious; reduce environmental stimuli
- Avoid restraints if possible. Seizure precautions
- Meds: antibiotics, anti-seizure meds, anti-pyretics. Treat fever aggressively
What are the TNIs for acute bacterial meningitis?
- Isolation - droplet precautions. Start IV with 1/2 NS (NO SUGAR IN FLUIDS)
- Collect specimens for cultures, start antibiotics
- Assess for SIADH - common complication (strict I/O, fluid restrictions, measure specific gravity, seizure precautions, etc)
What are symptoms and TNIs of bacterial meningitis in peds?
- High-pitched cry, bulging fontanels, poor feeding, extreme irritability
- Measure head circumference. Kernig/Brudzinski’s signs don’t work on infants. Signs of meningitis in an infant look like increased ICP
What is viral meningitis?
Viral infection of arachnoid mater and CSF
What are the signs and symtpoms of viral meningitis?
- Fever
- HA
- Photophobia and stiff neck
- Flu like and self-limiting
- No symptoms of brain involvement
What are the TNIs for viral meningitis?
Supportive care based on symptoms (fluids, rest, anti-pyretics)
What is encephalitis?
acute inflammation of the brain caused by bacteria, fungi, parasites, viruses
What are the signs and symptoms of encephalitis?
- Nonspecific onset with fever
- HA
- N/V
- any CNS abnormality (hemipareis, tremors, seizures, cognitive and/or personality changes)
What are the TNIs of encephalitis?
- Mosquito control (clean gutters, drain bird baths, no standing water)
- Supportive care based on symptoms (fluids, rest, anti-pyretics)
- Seizure precautions
What is a brain abscess?
Accumulation of pus within the brain tissue; can result in a local or systemic infection. Ears, sinuses - most common sources of infection.
What are the signs and symptoms of brain abscess?
- HA
- Fever
- N/V
- Increased ICP
- Confusion
- Drowsiness
- Focal neurological deficits
- Seizures
What are the TNIs for brain abscess?
- Antimicrobial therapy with supportive care based on symptoms
- TNIs for brain surgery if patient had abscess drained (HOB down, seizure precautions)