meningitis Flashcards
meningitis
infection in the subarachnoid layer (between arachnoid and pia)
meningitis s/s
headache, fever, nuchal rigidity (stiff neck), photophobia, lethargy, seizures
risk factors
children
travel exposure
immunocompromised
trauma to brain
diagnosis of meningitis
CSF analysis from lumbar puncture
kernigs sign
tests for nuchal rigidity
lay on back and flex hip 90 degrees. inability to extend knees= positive kernigs
brudzinkskis sign
tests for nuchal rigidity
supine and passively lift head up, if knee bends then positive sign
treatment for meningitis
steroids and antibiotics
antifungal, antivirals, antibacterial as indicated for underlying cause
bacterial meningitis
from hematogenous spread from BB barrier
complications of bacterial meningitis
increased ICP
optic nerve compressed
hemiparesis, dysphagia
noncommunicating hydrocephalus (CSF blocked to brain)
waterhouse-fridrechsen syndrome (adrenal glands stop working)
lumbar punct in bacterial
WBC increase, glucose decreases, protein increase, cloudy CSF
causes of bacterial meningitis
group b strep
pneumonia
e-coli
staphylococcus
viral meningitis vs bacterial
viral doesnt cause brain parenchyma
viral meningitis is from
from hematogenous spread due to Herpes Simplex Virus 2 or Varicella Zoster Virus.
enterovirus is most common cause
viral meningitis s/s
similar to bacterial but less severe
no brain parenchyma symptoms so no delerium, seizures, confusion
sometimes no nuchal rigidity
treatment of viral meningitis
supportive measures
acyclovir (for hereps)
precautions for meningitis
droplet
nursing considerations for meningitis
seizure precautions
neuro assess
quiet room and dim lights
minimize ICP ( HOB 30, head midline, minimize suctioning)
septic meningitis viral or bacterial
bacterial
prevention of meningitis (vaccines)
vaccination against Haemophilus influenzae and S. pneumoniae for all children and at-risk adults
