Meningitis/Encephalitis

Question 1

What part of the central nervous system does meningitis affect?

Answer 1

CSF and arachnoid mater

Question 2

How do you get bacterial meningitis?

Answer 2

Usually a secondary infection following a respiratory infection; bacteria can enter through bloodstream with head injuries too

secretions travel in CSF and spread throughout the brain

Question 3

Clinical manifestations of meningitis

Answer 3

fever, nuchal rigidity, photosensitivity, seizures, coma

positive kerning’s sign: hip is flexed at 90 degrees and pt can’t straighten their knee without severe pain

positive brudzinski’s sign: pt will flex their hip and knees when their neck is flexed due to severe pain

Question 4

Complications of meningitis

Answer 4

increased ICP (can cause changes in LOC), hearing loss, hemiparesis, dysphagia

acute cerebral edema: can cause seizures, bradycardia, hypertensive coma, and death

obstructed CSF flow: noncommunicating hydrocephalus

Question 5

Diagnostics for bacterial meningitis

Answer 5

blood cultures, x ray, CT scan, MRI

lumbar puncture: analysis of CSF (low glucose, high protein, positive for bacteria); NO lumber puncture with increased ICP

Question 6

Medical management of bacterial meningitis

Answer 6

can’t wait until cultures come back; need to start a broad spectrum antibiotic that crosses BBB (cephalosporins, penicillins, gentamicin) ASAP

Question 7

Nursing care of meningitis

Answer 7

darken room, reduce stimuli, pain management, seizure precautions, initial droplet precautions for the first 24 hr of antibiotic therapy

Question 8

Common causes of viral meningitis

Answer 8

HIV, enterovirus, arbovirus, HSV

presents similar to bacterial: HA, fever, photophobia, nuchal rigidity

Question 9

Medical management of viral meningitis

Answer 9

there will be no organisms found from lumbar puncture

manage symptoms until recovery

Question 10

What is the difference between meningitis and encephalitis?

Answer 10

meningitis: inflammation of the membranes that surround the brain and spinal cord (meninges)
encephalitis: inflammation of the brain itself

Question 11

Common causes of encephalitis

Answer 11

West Nile Virus, HSV, several other viruses

Trasmission: ticks & mosquitos

Question 12

Clinical manifestations of encephalitis

Answer 12

mild flu-like symptoms: fever, HA, N/V, tremors

hemiparesis, seizures, personality changes, amnesia, dysphagia

very rarely results in severe neuro disease

Question 13

Diagnostics for encephalitis

Answer 13

any kind of brain scan (CT, MRI, PET)

blood test for west nile

tests for HSV DNA/RNA