Meningitis

Question 1

What is the definition of meningitis?

Answer 1

Inflammation of the meninges of the brain

Question 2

What are the 3 types of meningitis?

Answer 2

Bacterial, Viral, Tuberculous

Question 3

What are causative agents of meningitis?

Answer 3

Streptococcus pneumoniae and Neisseria, Group B strep., e. coli, listeria

Question 4

What type of transmittable disease is meningitis?

Answer 4

Droplet

Question 5

What type can the baby be infected from from the mother?

Answer 5

Group B.

Question 6

How does bacterial meningitis start?

Answer 6

As an upper respiratory infection, then initiates swelling of meninges

Question 7

What is the incidence of meningitis?

Answer 7

Can occur at any time- flu is in the autumn/winter, pneumococcal and meningicoccal late winter and spring

Question 8

What is the pathophysilogy of bacterial meningitis?

Answer 8

Starts as inflammation, then exudation, then white blood cells are accumulated and tissue damage can occur– the brain becomes hyperemic and edematous

Question 9

Where does the purulent exudate extend to?

Answer 9

The 4 ventricles

Question 10

What does the thick pus, fibrin and adhesions obstruct?

Answer 10

The flow of CSF through the aqueduct of Sylvius

Question 11

What does the aqueduct of sylvius do?

Answer 11

connects the midline ventricles

Question 12

What are classic symptoms of meningitis?

Answer 12

Severe headache, dislike bright lights, fever, projectile vomitting, stiff neck, rapid breathing, drowsy, stomach, joint, muscle pains, rash

Question 13

What are early signs of meningitis?

Answer 13

Pale, blue, dusky skin around lips, severe leg pain, cold hands or feet, high temperature

Question 14

What are clinical manifestations in infants and young children of bacterial meningitis?

Answer 14

fever, vomitting, poor feeding, irritability, seizures, buldging fontanels, stiff neck, rash

Question 15

What are clinical manifestations in older children and teens of bacterial meningitis?

Answer 15

fever, chills, severe headache, vomitting, stiff neck, Kernigs and Brudzinski’s signs, rash, photophobia, seizures

Question 16

What is Kernig’s Sign?

Answer 16

Positive sign means they cannot straighten their leg because of how stiff the hamstring is

Question 17

What is Brudzinski’s Sign?

Answer 17

Positive is when the neck is stiff and they have to flex their knees and hips to flex their neck

Question 18

How is bacterial meningitis diagnosed?

Answer 18

By Lumbar puncture, sometimes blood and nasal cultures

Question 19

Nursing responsibilities for lumbar puncture

Answer 19

Keep back curved, keep child still, lay them on their side or sit upright, keep the field sterile- then comfort them after, teach parents about the procedure before

Question 20

What type of isolation is the child on?

Answer 20

Respiratory- droplet and contact procautions

Question 21

What are some therapeutic management techniques?

Answer 21

maintain hydration and ventilation, reduce ICP, manage shock, control seizures and temperature, correct anemia

Question 22

What is a normal ICP?

Answer 22

5-15mmHG

Question 23

What types of drugs would be used to treat bacterial meningitis?

Answer 23

Antibiotics- 10 days, rocephin, cefotaxine, vancomycin
Steroids- Dexamethosone
Headache- Acetaminophen
Antipyretics- Hydrate and acetaminophen

Question 24

Bacterial meningitis treatment in the hospital

Answer 24

Maintain ventilation, monitor respiratory status, keep room quiet, dark, no noise, control seizures, administer meds- AVOID NARCOTICS, neuro assessment, strick I&O, measure head circumference

Question 25

What are some complications of bacterial meningitis?

Answer 25

hydrocephalus, subdural effusion, thrombosis in meningeal veins, brain abscess, deafness, blindness, weakness, paralysis of face/neck

Question 26

What is SIADH?

Answer 26

Hyponatremia and excessive release of the antidiuretic hormone– make the brain retain fluid, needa hypertonic solution and loop diuretic

Question 27

What are signs and symptoms of SIADH?

Answer 27

Water retention, lethargy, coma, seizures, nausea, vomitting, electrolyte imbalance, edema

Question 28

What is waterhouse-Friderichsen syndrome?

Answer 28

Sudden, rapid, severe onset of overwhelming septic shock, causes DIC and massive bilateral adrenal hemorrhage and purpura (usually with Nisseria)

Question 29

What is DIC?

Answer 29

Deceminated Intravascular Cementation- the blood is unable to clot- treat with heparin to stop the cascade

Question 30

What are some residual effects of complications related to bacterial meningtis?

Answer 30

Seizure disorders, hearing loss, vision loss, mental retardation, cognitive delays, may need a ventricular peritoneal shunt

Question 31

How do you prevent bacterial meningitis?

Answer 31

Treat infections immediately, keep up with immunizations, rifampin to those exposed

Question 32

What is viral meningitis?

Answer 32

Inflammation of the meninges associated with past exposure to measles, mumps, herpes, leukemia, and enteroviruses

Question 33

What is the pathophysiology of viral meningitis?

Answer 33

Caused by enteroviruses from sputum, saliva, or mucousa with spontaneous subsiding of symptoms with no residual effects

Question 34

Clinical manifestations of viral meningitis

Answer 34

Same as bacterial, different kind of rash

Question 35

How do you diagnose viral meningitis?

Answer 35

Lumbar puncture- differentiates between bacterial and viral- negative bacterial culture

Question 36

How do you treat viral meningitis?

Answer 36

Treat symptoms- self limiting disease. Decrease stimulu, control fever, hydrate, antibiotics until viral is confirmed