Pediatric Neuro Disorders Flashcards
What is the most common form of meningitis?
Viral Meningitis
What is the most serious form of meningitis?
Bacterial Meningitis
Which vaccines are given for prevention of bacterial meningitis?
Hib and PVC
What are symptoms of meningitis?
- sensitivity to light
- headache
- GI upset
- irritability
- high-pitched cry in infants
- fever
- poor feeding
- nuchal rigidity
- bulging fontanels in infants (late sign)
- seizures
- positive Brudzinski’s sign
- positive Kernig’s sign
Which organism causes bacterial meningitis?
Haemophilius influenzae type B (less prevalent), Streptococcus pneumoniae or Neisseria meningitidis
What is the usual source of bacterial invasion in meningtits?
Middle ear or nasopharynx
What is the profile of a positive bacterial meningitis lumbar puncture?
- cloudy CSF
- increased WBC
- decreased glucose
- elevated protein
- increased ICP
- positive gram stain
What is the profile of a viral meningitis lumbar puncture?
- clear CSF
- normal protein and glucose
- negative gram stain
What are priority nursing interventions in the case of suspected meningitis?
- Initiate droplet precautions and continue at least 24 hours after start of antibiotics
- keep NPO if changes in LOC are present
- provide a dark, quiet envrionment
- observe for signs of increased ICP
What are symptoms of increased intra-cranial pressure?
- bulging fontanels in infants
- high pitched cry in infants
- increase in head circumference
- irritability
- bradycardia
- headache
- seizures
- changes in respiration
What is an important step in preparing a patient for a lumbar puncture?
Empty bladder
What is Reye Syndrome?
An acute, life-threatening and rapidly progressing condition causing encephalopathy and hepatic dysfunction.
What is a risk factor for Reye Syndrome?
Administration of aspirin to pediatric clients who have been exposed to viral illness (such as flu and chickenpox).
Signs and symptoms of Reye Syndrome?
- lethargy, rapidly progressing to deep coma
- vomiting
- elevated AST and ALT (liver enzymes)
- elevated ammonia
- decreased PT
- hypoglycemia
What are nursing interventions for Reye Syndrome?
- provide critical care early
- monitor ICP and neuro status
- maintain ventilation
- administer Mannitol if prescribed to increase blood osmolality
- monitor I/O
- Foley catheter care
