MENINGITIS

Question 1

what are clinical manifestations of meningitis in the newborn?

Answer 1

1. NO nuchal rigidity
2. poor muscle tone
3. weak cry
4. late sign: bulging fontanels
5. poor suck/refuses feeding which causes a weak appetite

Question 2

what are clinical manifestations of meningitis in a baby 3 months-2 years old?

Answer 2

1. seizures
2. bulging fontanels
3. possible nuchal rigidity
4. Brudzinski’s and Kernig’s not reliable tests at this age

Question 3

what are clinical manifestations of meningitis in a baby 2 years and older?

Answer 3

1. seizures are the initial sign
2. rash (meningcoccal)
3. positive brudzinski’s sign
4. positive kernig’s sign
5. nuchal rigidity

Question 4

what is the a positive brudzinski’s sign?

Answer 4

neck flexion that leads to hip/knee flexion

Question 5

what is a positive kernig’s sign?

Answer 5

unable to extend knee beyond 135 degrees

Question 6

what exactly is the lumbar puncture test for meningitis?

Answer 6

spinal needle in subarachnoid space between L3 and L4 or L4 and 5

Question 7

what type of CSF will a patient with bacterial meningitis have?

Answer 7

cloudy CSF, elevated protein and WBC, decreased glucose and a positive gram stain

Question 8

what type of CSF will a patient with viral mengingitis have?

Answer 8

clear, slightly elevated WBC and protein, normal glucose, and a negative gram stain

Question 9

what type of infection precautions should the meningitis patient be on?

Answer 9

droplet precautions for 24 hours after initiation of antibiotics

Question 10

what position should the baby be lying in during the lumbar puncture procedure?

Answer 10

have the baby in a side lying with the head flexed and knees drawn up towards the chest in a fetal position

Question 11

what position should the infant lie in after the lumbar puncture procedure?

Answer 11

instruct the patient to remain in bed in a flat position afterwards to prevent leakage of spinal headache

Question 12

what are nursing interventions to follow with a baby who has mengintiis?

Answer 12

1. comfort measures such as cool room, no pillow, slightly elevated HOB, side lying position
2. safety such as bed in lowest position and seizure precautions
3. increase in ICP can occur so decrease by positioning HOB at 30 degrees, avoid coughing, straining, and bright lights