MENINGITIS SDLP

Question 1

What is meningitis?

Answer 1

Meningitis is the inflammation of the meninges which is the soft tissue covering the brain and spinal cord

Question 2

Bacterial meningitis is….

a. An acute inflammation of the brain’s grey matter.
b. A chronic infection of the medulla.
c. A life-threatening inflammation of the meninges and spinal cord caused by a bacterial infection.
d. Inflammation/infection of the optical nerve causing compression of and swelling to the surface of the brain

Answer 2

C: A life-threatening inflammation of the meninges and spinal cord caused by a bacterial infection.

Question 3

Which is not a typical symptom of meningitic illness?

a. Fever
b. High pitched cry
c. Photophobia
d. Excessive urine output

Answer 3

D) Excessive urine output

Question 4

Drugs commonly given for the treatment of bacterial meningitis include

a. Cefotaxime
b. Penicillin
c. Amoxycillin
d. Flucloxicillin

Answer 4

A) Cefotaxime

b. Penicillin

Question 5

The results of a Full Blood Count test from a child with bacterial meningitis would show…..

a. ↓CRP
b. ↑Neutrophils
c. ↑Lymphocytes
d. Normal White Cell Count

Answer 5

B) ↑Neutrophils

Question 6

The incubation period for bacterial meningitis is most commonly;

a. 12 - 24hours
b. 3-6 weeks
c. 1 - 10 days
d. 1 month

Answer 6

C) 1 - 10 days

Question 7

Which type of isolation is required for the child who has or is suspected of having bacterial meningitis?

a. Green ~ Enteric
b. White ~ Strict
c. Blue ~ Respiratory
d. Pink ~ Wound

Answer 7

c. Blue ~ Respiratory

Question 8

If a child is suspected of having bacterial meningitis, which investigations are routinely carried out?

a. Blood Cultures
b. Lumbar Puncture
c. Urea & Electrolytes
d. Stool sample.

Answer 8

A) Blood Culture
B) Lumbar Puncture
C) Urea & Electrolytes

Question 9

Because the risk of contracting bacterial meningitis is high, no visitors are allowed until the child has received 3 days of treatment.

a. True
b. False

Answer 9

b. False

Question 10

Does my baby cry when I pick him/her up?

Answer 10

Babies with meningitis become very irritable and restless and dislike being handled

Question 11

Why do you need to stick a needle in his/her back?

Answer 11

Diagnosis is made by testing the fluid that circulates around the brain and spinal cord (csf) to try to isolate the bacteria and the needle is essential to obtaining a sample of csf.

Question 12

How long will we be in hospital?

Answer 12

The length of stay depends on the length and severity of illness, but the baby will need to receive approximately 10 days of Intravenous antibiotics

Question 13

Will my 2 year old at home have meningitis?

Answer 13

Not necessarily but is at risk of developing meningitis due to close contact with the baby and will need to be seen by a doctor and given some prophylactic antibiotics and observed and if become unwell bring into hospital to exclude meningitis.

Question 14

Do I need to let the school know of his/her illness?

Answer 14

The health department will identify those contacts considered at risk and they may contact the school as a precaution. They will need to know which school and who the affected child has had close contact with over the last 7 days

Question 15

Can he/she have a drink and/or paracetamol?

Answer 15

This depends on how ill the child is, they may be on a fluid restriction but may be able to take small measured amounts orally. Paracetamol may be given for pain relief if it is determined as the most appropriate analgesia by the medical staff.

Question 16

There are 3 strains of bacterial meningitis.\

a. True.
b. False.

Answer 16

b. False.

Question 17

A child could have normal Full Blood Count results if:

a. He/she has been taking Oral Antibiotics at home
b. Is in the early stages of the disease
c. Is recovering from Bacterial Meningitis independently
d. Is drinking excessively, thus diluting the concentration of bacterial cells in the blood.

Answer 17

b. Is in the early stages of the disease

Question 18

Laura is two-year-old who attends day-care 3 days per week and her mum Sally is 25
weeks pregnant. Laura has been unwell, Sally reports that she was called by day care earlier in the day to say that Laura had a fever and had vomited. Since picking Laura up from day care Sally had noticed Laura’s irritability had increased and this had prompted Sally to bring Laura to a busy emergency dept. Doctors have diagnosed bacterial meningitis and she has been admitted to the ward;

A. Describe what investigations Laura will require to confirm diagnosis
B. Write a plan of care for Laura include routine care for a child with bacterial meningitis
C. Describe the infection control precautions that are going to be required for those that have been in close contact with Laura over the last few days.

Answer 18

A = Lumbar puncture is the definitive diagnostic test for culture and sensitivity, gram stain, blood cell count in the CSF.
Other tests include blood cultures to rule out septicaemia, full blood picture to look for raised white cell count- neutrophils, Urea and electrolytes and glucose level.

B = The care of the child with meningitis is determined by the child’s symptoms.
Points to consider;
• Infection control precautions within the hospital
• Infection and Antibiotic cover
• Comfort/pain related issues and analgesia
• Fluid support and fluid balance
• Observation of vital signs and level of consciousness
• Environmental stimulation-quiet, darkened room, minimal handling
• Maintaining a safe environment- awareness of possibilities of medical emergencies ie respiratory depression/arrest/ seizures
• Dietary provision
• Family support and education
• Complications
• Public health issues related to family daycare
• Discharge planning

C. Department of Health must be notified, this is the responsibility of the medical staff. Exposed contacts need to be traced and notified, this is the responsibility of the dept of health and medical staff, and seek medical attention immediately if start to show symptoms of febrile illness. Anyone who has been in recent contact with the primary case will require prophylactic antibiotics preferably within 24 hours of diagnosis of the primary case. Exposed contacts are usually household members, childcare and school contacts only. See infection control manual.