Encephalitis

Question 1

Encephalitis Patho:

Answer 1

• Acute, inflammatory process of the brain tissue
• Virus gains access to CNS via cerebral capillaries
• local necrotizing hemorrhage that becomes more generalized, followed by edema.
• Inflammation of the entire brain
• usually from viral infection (HSV/ west Nile)

Question 2

*Encephalitis Causes:

Answer 2

• *include viral infections (herpes simplex [HSV])
  — The herpes simplex virus (HSV) is the most common cause of acute encephalitis in the U.S.

Question 3

Encephalitis Signs & Symptoms:

Answer 3

• Confusion
• Hallucinations
• N&V
• Pupils dilated
• Increased ICP: hyper-reflexes, vertigo, death
• LOC: lethargic- comatose
• Mental status changes: irritable/ confused
• Headache
• Fever
• stiff neck
• Neuro dysfunction reflecting area of brain involved
• Personality change - especially with frontal lobe involvement
• Motor changes
• Rash with nerve irritation

Question 4

Encephalitis Nursing management

Answer 4

• Similar nursing care to meningitis
• Start treatment early (because it progresses quickly)
• Frequent and ongoing assessment
• Supportive care
• Mosquito or tick bite can also transmit West Nile
• Neurologic assessment: key to monitoring the progression - of disease.
• Opioid analgesic medications may mask neurologic symptoms.
• Comfort care: decrease lighting and noise
• Monitor prevent immobility complications
• Seizure precautions
• Permanent disabilities
• Family anxiety

Question 5

Encephalitis Diagnostics:

Answer 5

• Lumbar puncture (CSF)
  — increased pressure/ protein levels
  — Glucose levels WNL
  — HSV-1
• EEG
  — shows diffuse slowing or focal changes in the temporal lobes
• MRI
  — shows edema

Question 6

Encephalitis Medical management

Answer 6

Antiviral agents
- MOA: inhibition of viral DNA replication.
— Acyclovir (IV) for HSV infection
— Valtrex (PO) (Check LOC)