MENINGITIS Flashcards

1
Q

An inflammation of the fluid and membranes (meninges) surrounding the brain and spinal cord.

A

Meningitis

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2
Q

Inflammatory response to infection causes increase or decrease ICP?

A

increase ICP

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3
Q

Causative Agents of Meningitis?
tip: SP, HI, NM

A

 Streptococcus Pneumoniae
 Hemophilus Influenzae
 Neisseria Meningitidis

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4
Q

Causative Agents of Meningitis?

A

SP, HI, NM

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5
Q

Causative Agents of Meningitis?

A

 Streptococcus Pneumoniae
 Hemophilus Influenzae
 Neisseria Meningitidis

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6
Q

Meningitis 2 Modes of Transmission:

A

 Droplet
 Direct Contact

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7
Q

Incubation Period:

A

2-10 days

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8
Q

Average incubation period:

A

 Average: 6-7 days

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9
Q

Diagnostic test to collect CSF

A

Lumbar Tap

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10
Q

Definitive diagnostics of meningitis:

A

Lumbar Tap

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11
Q

Lumbar Tap Position:

A

Fetal position

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12
Q

Test done before aspirating CSF

A

Queckenstedt’s Test

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13
Q

Test for arachnoid obstruction

A

Queckenstedt’s Test

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14
Q

MENINGISTIS PATHOGNOMONIC Signs and Symptoms:

A
  1. Nuchal Rigidity: Pain upon flexion of the neck
  2. Kernig’s Sign: Pain upon straightening of the leg
  3. Brudzinski’s Sign: Flexion of the knee upon flexion of the neck
  4. Opisthotonos: Severe arching of the back
  5. Decortication
  6. Decerebration
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15
Q

MENINGISTIS PATHOGNOMONIC Signs and Symptoms: Pain upon flexion of the neck

A
  1. Nuchal Rigidity
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16
Q

MENINGISTIS PATHOGNOMONIC Signs and Symptoms: Pain upon straightening of the leg

A
  1. Kernig’s Sign
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17
Q

MENINGISTIS PATHOGNOMONIC Signs and Symptoms: Flexion of the knee upon flexion of the neck

A
  1. Brudzinski’s Sign
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18
Q

MENINGISTIS PATHOGNOMONIC Signs and Symptoms: Severe arching of the back

A
  1. Opisthotonos
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19
Q

5th and 6th MENINGISTIS PATHOGNOMONIC Signs and Symptoms?
tip: D, D

A
  1. Decortication
  2. Decerebration
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20
Q

Signs and Symptoms of ↑ ICP: Cushing’s Triad.
Name its 3 characteristics.

A

Hypertension. Bradycardia. Bradypnea.

HYPER-BRADY-BRADY

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21
Q

Signs and Symptoms of ↑ ICP: ___ characterized by a difference in pupil sizes

A

Anisocoria

22
Q

Cranial nerve effected on Anisocoria

A

CN3

23
Q

Signs and Symptoms of ↑ ICP: ___ characterized by a double vision

A

Diplopia

24
Q

Cranial nerve effected on Diplopia

A

CN6 (Abducens)

25
Q

Deconjugate movement of the eye

A

Doll’s Eye Sign

26
Q

5 other Signs and Symptoms of ↑ ICP:

A

 High temperature
 N/V
 Photophobia
 Seizures
 Wide Pulse Pressure

27
Q

Increase ICP management. Position: Semi Fowler’s rationale

A

Semi Fowler’s to:
Promote lung expansion
Drain excess CSF

28
Q

Increase ICP management.  HOB Elevation:

A

HOB Elevation: 30-45˚

NOT 90˚ -it can cause Brain Herniation

29
Q

Increase ICP management.
 Safety
 Limit fluid intake: ___ CSF

A

to decrease CSF

30
Q

Increase ICP management. Rest:

A

Physical activity would be a stimulus for possible seizure

31
Q

Name factors to avoid that ↑ ICP:

A

Bending,
Stooping,
Valsalva maneuver,
Cough,
Sneezing

32
Q
A
33
Q

4 Meningitis Pharmacologic Management

O-C-A-A

A
  1. Osmotic Diuretics
  2. Corticosteroids
  3. Anticonvulsants
  4. Antacids
34
Q

DOC

A

Mannitol

35
Q

Mannitol acts to ↓ cerebral edema. WOF?

A

Hypotension and dizziness

36
Q

DOC of Corticosteroids:

A

Dexamethasone/ Decadron

these drugs could cross BBB

37
Q

Anticonvulsants: DOC

A

Dilantin/Phenytoin

38
Q

Phenytoin, if given PO, administer with meals because?

A

Causes GI upset

39
Q

Phenytoin if given per IV, prepare 10ml NSS, why?

A

Crystalizes in veins

40
Q

Method to administer 5ml NSS, phenytoin, 5ml NSS.

A

Sandwich Method

41
Q

SIDE EFFECTS: Anticonvulsants: Dilantin/Phenytoin

A

 Causes GI upset
 Nystagmus (uncontrolled eye movement)
 Red urine
 Overgrowth of gum tissues
 Gingival Hyperplasia

42
Q

Gingival Hyperplasia Nursing Intervention:

A

Soft bristle toothbrush

43
Q

Meningitis Pharmacologic Management -Antacids: H2 Receptor Blockers to?

A

prevent GI upset (please validate this info)

44
Q

Phenytoin Therapy Side Effects

A

 Gastric Ulcers
 Red Urine
 Ataxia
 Nystagmus
 Bone Marrow Depression: Cause aplastic anemia

45
Q

Meningitis Collaborative Management:
Bedrest: _____ and ________

A

 Bedrest: Dark room and cool over eyes

46
Q

Meningitis Collaborative Management: PenG

A

Antibiotics IV: Codeine (Opioids) – causes respiratory depression, dizziness, constipation

47
Q

Meningitis Collaborative Management:DOC for severe headache

A

Glucocorticoids: Dexamethasone

48
Q

Meningitis Collaborative Management: DOC for temperature above ↑ 38˚C;

A

Paracetamol

49
Q

Meningitis Collaborative Management: DOC to relieve cerebral edema:

A

Mannitol

50
Q

Meningitis Collaborative Management:
-Assess BP
-DOC to prevent seizures?

A

Phenytoin/Dilantin