meningitis Flashcards
What is the function of the meninges?
surround brain and spinal cord. Cushion, protect, and create CSF
What 3 layers does the meninges consist of?
- -dura mater
- -arachnoid
- -pia mater
Why can bacteria multiply without causing inflammation?
Because CSF contains low amount of WBC’s
What are the 3 types of meningitis?
- -Viral
- -fungal
- -bacterial
What viruses can cause viral meningitis?
- -enterovirus
- -arborvirus (west nile)
- -herpes simplex virus
What fungal spores can cause fungal meningitis?
–Crytpococcus neoformans
What people are at higher risk for getting fungal meningitis?
- -diabetes
- -HIV
- -Cancer
Bacterial meningitis can be life threatening and requires immediate medical attention. What types of bacteria can cause bacterial meningitis?
- -streptococcus pneumoniae
- -Neisseria Meningitidis
- -Group B strep
What are some illnesses that can cause bacterial meningitis?
- -otitis media
- -sinusitis
- -pneumonia
what are some illness that can cause viral meningitis?
- -measles
- -mumps
- -west nile
- -herpes
What are some other risk factors for acquiring meningitis?
- -immunocompromised
- -contaminated CSF
- -skull fracture, invasive procedures, penetrating wounds
- -dorms, shelters
What are some clinical manifestations of meningitis?
- -high fever
- -headache (may have N/V with it)
- -nuchal rigidity
- -photophobia
- -confusion
- -seizures
- -+ kernigs sign
- -+ Brudzinskis sign
- -Rash
What type of meningitis is associated with a red macular rash?
meningococcal meningitis
Early meningitis mimics the…
flu
What are some clinical manifestations seen in newborns/infants?
- -constant, weak cry
- -difficult to comfort (cry harder when held)
- -Sluggish
- -Poor feeding
- -stiff body and neck
What would indicate a late sign of meningitis in a newborn/infant?
bulging fontanels
What should be ruled out if meningitis is suspected with an elderly patient?
UTI (both meningitis and UTI cause confusion)
What is nuchal rigidity?
When a patient has a stiff neck and cannot put head down toward chest
What is kernigs sign?
Stiffness of hamstring which causes inability to straighten leg when hip flexed 90 degrees
What is a Brudzinski’s sign?
severe neck stiffness that causes a patients hips and knees to flex when the neck is flexed.
What are some lab test that can be done to diagnose meningitis?
- -CBC
- -Culture and Sensitivity
- -CSF analysis
- -CT and MRI
What areas should be tested with the culture and sensitivity test?
- -urine
- -throat
- -nose
- -blood
What is the most definitive test for meningitis?
CSF analysis
If the meningitis is bacterial the CSF fluid will be…
cloudy
If the meningitis is viral the CSF fluid will be….
clear
If the CSF analysis is positive for meningitis, what will it show?
- -cloudy/clear CSF
- -elevated WBC’s
- -Elevated protein
- -Decreased glucose
- -elevated CSF pressure
Why would the CSF analysis show decreased glucose?
because bacteria eat glucose
What antibiotics would be given to a person with bacterial meningitis?
–ceftriaxone/cefotaxime with vancomycin
prophylactic until results in
What antibiotics would be given phrophylactic to people in close contact with client?
- -cipro
- -rifampin
- -ceftriaxone
What other meds can be given to a patient with meningitis?
- -analgesic (Tylenol/ibuprofen)
- -phenytoin (anticonvulsant)
- -Dexamethasone (corticosteroid for inflammation)
Why do we not give opioids to someone with meningitis?
mask changes in LOC
What are some non-pharm treatments for meningitis?
- -bed rest
- -HOB 30 degrees
- -increase fluids
- -limit visitors
What type of Standard precaution would a patient with meningitis be on?
Droplet
How long will a patient need to be on droplet precautions for?
until been on antibiotics for 24 hours (some may need to stay on droplet)
Who should meningitis be reported to?
Public health dept.
What are some nursing care interventions the nurse can provide?
–reduce fever
–decrease stimuli (quiet, and dark)
–monitor for ICP
Tell client not to cough or sneeze
-monitor VS, neuro status q2-4 hours
–assist with ADL’s
what type of safety precaution would the patient be on?
Seizure precautions (pad rails) --bed lowest position, call light within reach
What are some interventions that can be done to reduce ICP?
- -HOB above 30 degrees
- -dont cough/sneeze/strain
- -reduce stimuli
What med can be given to a patient with ICP?
IV mannitol
What are 3 vaccines that can help prevent meningitis?
- -Hib
- -PPSV
- -MCV4
How many doses of Hib is given and what is the age?
- -4 doses
- -@ 2 months and final dose at 12-15 months
Who do we give the PPSV vaccine?
> 65 yoa
- -immunocompromised
- -chronic disease
- -smoke
- -live in long term care facility
The MCV4 vaccine can help prevent what type of meningitis?
Neisseria Meningitis
When should MCV4 be given?
–Prior to going to military/college dorm
When is the initial dose of MCV4 given and when is the booster given?
- -11-12 yoa
- -16 yoa
Where is the needle inserted in a lumbar puncture?
between L3 and L4, or L4 and L5
What should the nurse tell the patient to do prior to a lumbar puncture?
void
What position would the patient be in prior to a LP?
–side lying with head flexed and knees toward chest
What is applied after a lumbar puncture?
pressure and elastic bandage
What should the nurse monitor for after a LP?
- -bleeding
- -hematoma
- -infection
What position should a patient be in after a LP?
–flat in bed to prevent leakage of spinal fluid which can cause spinal headaches
