Meningitis Flashcards
Pathophys of meningitis
Bacteria/virus –> respiratory system/bloodstream or skull wound –> CNS infection, increased CSF and ICP
Name the most common bacterial culprits for meningitis (2 and one ‘extra’)
-Streptococcus pneumoniae
-Neisseria menigitidis
-Haemophilus influenzae used to be a common cause before widespread vaccination
Who is at higher risk for meningitis?
-younger populations (kiddos, adolescents)
-people living in crowded conditions (school/universities, care homes, incarcerated people)
_________ meningitis is an emergency that requires immediate hospitalization, while ________ meningitis can usually be managed at home and has much milder symptoms.
How does this difference influence how we care for patients presenting with generalized s/s of meningitis?
-Bacterial, viral
-we treat all cases of meningitis as if they are bacterial until proven otherwise
What lumbar puncture results would indicate bacterial meningitis? What would indicate viral meningitis?
Bacterial:
-high pressure
-high proteins
-high neutrophils
-low glucose
-cloudy/turbid color
Viral:
-high lymphocytes
-more or less clear color
Describe the nursing management of non-specific meningitis
- MASK UP asap
- draw cultures, CBC, CMP, BG, organ function labs
- begin broad spectrum antibiotics
- seizure prophylaxis (dim lighting, reduce noise, pad side rails)
Presence of blood in an initial lumbar puncture sample usually indicates:
some slight trauma occurred during the puncture
Describe a positive Kernig’s sign, and Brudzinki’s sign:
-Kernig’s: worsening head/neck pain with hip/knee flexion
-Brudzinki’s: hip/knee flexion with neck flexion
During your assessment of a patient with bacterial meningitis, you note the following:
-petechiae
-bleeding gums
This indicates what complication?
Waterhouse Fredrichsen Syndrome
Papilledema and blindness indicate damage to which cranial nerve(s)?
-2, optic
Ptosis (drooping eyelid), unequal pupil sizes, and diplopia (double vision) indicate damage to which cranial nerve(s)?
-3, oculomotor
-4, trochlear
-6, abducens
Loss of sensation and the corneal reflex (blinking when cornea is touched) indicate damage to which cranial nerve(s)?
-5, trigeminal
Facial paresthesias and paresis (paralysis) indicate damage to which cranial nerve(s)?
-7, facial
Tinnitus –> vertigo –> deafness (potentially permanent) indicates damage to which cranial nerve(s)?
-8, vestibulocochlear
Medications for bacterial meningitis
-IV antibiotics: ampicillin, ceftriaxone, penicillin
-IV Mannitol to treat increased ICP
-phenytoin, if ordered, for seizure prophylaxis
