Neurology Flashcards
Routes of Entry for Central Nervous System Infections
Blood Stream
Direct extension
Cerebrospinal fluid
Nose or mouth
In utero
Meningitis
Inflammation of the meninges that surround the brain and spinal cord, caused by either bacterial or viral infection.
Bacterial Meningitis
serious infection spread by direct contact with discharge from the respiratory tract of an infected person
Viral Meningitis
Also called aseptic meningitis, is more common and rarely serious. It usually presents with flu-like symptoms, and patients recover in 1 to 2 weeks.
Most common bacteria that cause meningitis
-Neisseria meningitidis -Streptococcus pneumoniae
-Group B Streptococcus, and
-Haemophilus influenzae type b (Hib).
Meningitis Prevention
Vaccines
Prophylactic treatment
Meningitis S/S
-Nuchal rigidity
-Positive Kernig and Brudzinski signs
-Fever
-Photophobia
-Petechial rash on skin and mucous membranes
-Encephalopathy
-No appetite or thirst
-Severe headache
Meningitis Complications
Cranial nerve damage
Seizures
hearing, vision, or cognitive deficits
Meningitis Diagnostic Tests
Lumbar puncture with cerebrospinal fluid, analysis, culture and sensitivity (C&S)
Complete blood count (CBC)
C&S nose and throat
Meningitis Therapeutic Measures
Antimicrobials (if bacterial)
Seizure precautions
Antipyretics
Pain management
Reduction of environmental stimuli
Education
Droplet isolation if contagious
Encephalitis
Pathophysiology
inflammation of brain tissue. Nerve cell damage, edema, and necrosis cause neurologic findings in the areas of the brain affected.
Encephalitis Etiology
Virus (West Nile, Mumps, Mono, Ticks)
-HSV (most common)
Encephalitis S/S
Headache
General malaise
N/V
fever over several days
nuchal rigidity
confusion
decreased LOC
seizures
photophobia
ataxia
abnormal sleep patterns
tremors
hemoparesis
Encephalitis Complications
Cognitive disabilities
Behavioral changes
Ongoing seizures
Motor deficits
blindness
Encephalitis Diagnostic Tests
Ct Scan
MRI
Lumbar puncture to obtain CSF
EEG
-CSF shows: increased WBC and protein level, with NML glucose
Encephalitis Therapeutic Measures
Neuro vitals
Anticonvulsants
Antipyretics
Analgesics
Corticosteroids
Sedatives
Antivirals
Increased Intracranial Pressure
Pathophysiology
IICP Risk Factors
Infection (meningitis)
Aneurysm
Seizures
Tumors
Stroke
IICP S/S
*Vomiting
*Headache
*Dilated pupil on affected side
*Hemiparesis or hemiplegia
*Decorticate then decerebrate posturing
*Decreasing level of consciousness
*Increasing systolic blood pressure
*Increasing then decreasing pulse rate
*Rising temperature
IICP Diagnostics
ICP monitoring
Glasgow Coma Scale
Brain Oxygenation
IICP Treatment
Diuretics
Anticonvulsants
Corticosteriods
IICP Therapeutic Interventions
Immobilize head if a neck injury is suspected.
-maintain HOB at 30 degrees
-Adm stool softeners
-Avoid endotracheal suction for >10 seconds
IICP patient education
Avoid:
coughing
sneezing
blowing nose
bending over/flexing at the hips
Seizure Precautions
*Pad side rails of hospital bed with commercial pads or bath blankets folded over and pinned in place.
*Keep call light within reach.
*Assist patient when ambulating.
*Keep suction and oral airway at bedside.
Nursing Care During a Seizure
*Stay with patient.
*Do not restrain patient.
*Protect from injury (move nearby objects).
*Loosen tight clothing.
*Turn to side when able to prevent occlusion of airway or aspiration.
*Suction if needed.
*Monitor vital signs when able.
*Be prepared to assist with breathing if necessary.
IICP Patient Education
The nature and focus of teaching depend on the patient’s LOC and cognitive status. When appropriate, include both the patient and family members in the education process
IICP Prevention
- Keep head of bed elevated 30 degrees unless contraindicated.
- Avoid flexing the neck; keep head and neck in midline position
- Administer antiemetics and antitussives as necessary to prevent vomiting and cough.
- Administer stool softeners.
- Minimize suctioning. If absolutely necessary, oxygenate first and limit suction passes to one or two.
- Avoid hip flexion.
- Prevent unnecessary noise and startling the patient.
- Space care activities to provide rest between each disturbance.
Seizure Disorders
A seizure can be a symptom of epilepsy or other neurologic disorders such as a brain tumor or meningitis
