T3 - Meningitis (Josh) Flashcards

1
Q

What is meningitis?

A

irritation of meninges of the brain due to a bacterial or aseptic infection

potentially fatal

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2
Q

Patho of meningitis?

A

After bacteria reach the central nervous system, the pia mater, the arachnoid, and the CSF–filled subarachnoid space become infected.

The CSF then circulates the pathogens throughout the brain and spinal cord.

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3
Q

What type of position does bacterial meningitis cause?

A

opisthotonic position,

  • neck and head hyperextended, to relieve discomfort.
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4
Q

S/S of Meningitis

A

Nuchal rigidity

Fever

Lethargy/irritability

Abrupt onset

Poor feeding

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5
Q

Possible complications form Meningitis

A

DIC

Subdural effusion

Sepsis

Septic Arthritis

Seizures

Hearing Loss

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6
Q

Meningitis S/S look like –

A

ICP s/s

  • Seizures
  • Shrill cry
  • Vomiting
  • Bulging fontanel
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7
Q

Test for which signs w/ Meningitis.

A

Kernig

Brudzinski

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8
Q

Bacterial meningitis is — of the meninges cause by –

A

inflammation

release of TNF that initiates the inflammatory process

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9
Q

Which vaccine has decreased risk of bacterial meningitis?

A

H Influenzae

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10
Q

Clinical manifestations of Meningitis

A

Abrupt onset

Fever, chills, h/a, vomiting, change in sensorium

Infants may not feed well

Seizure (may be initial sign) irritable, agitated, photophobia, confusion, hallucinations, stupor, coma

Nuchal rigidity (pain with neck flexion)

Posture

Kernig and Brudzinski signs are positive (for pain)

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11
Q

Sign of Meningitis:

Severe neck stiffness causes the knees to flex when neck is raised

A

Brudzinski Sign

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12
Q

Sign of Meningitis

Severe hamstring stiffness causes inability of leg to straighten when raised 90 degrees.

A

Kernig sign

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13
Q

Meningitis Complications

A

Obstructive hydrocephalus

Subdural effusions, anoxia / cell death

Blindness, deafness, weakness

Meningococcal sepsis- septic shock, DIC, 90% mortality

SIADH, seizures, cerebral edema, herniation

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14
Q

In Meningitis, – is elevated and – is reduced.

A

Protein

Glucose

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15
Q

How long is isolation for Meningitis?

A

24 hours

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16
Q

Another sign of Meningitis?

A

Purpura on skin

17
Q

Kernig’s Sign

A

Raise the child’s leg with the knee flexed.

Then extend the child’s leg at the knee.

If any resistance is noted or pain is felt, the result is a positive Kernig sign.

This is a common finding in meningitis. sign in meningitis.

18
Q

Brudzinski Sign

A

Flex the child’s head while in a supine position.

If this action makes the knees or hips flex involuntarily, a positive Brudzinski sign is present.

This is a common sign in meningitis.

19
Q

CSF Appearance:

A

Normal: clear

Bacterial Meningitis: cloudy, turbulent, purulent

Viral Meningitis: clear or slightly cloudy

20
Q

CSF Pressure:

A

Normal: 70-180 mmH2O

Bacterial Meningitis: elevated

Viral Meningitis: normal or elevated

21
Q

WBC in CSF:

A

Normal: 0-5, 8, or 15

Bacterial Meningitis: elevated 1000 or more per mm

Viral Meningitis: elevated 500 or more per mm

22
Q

Normal Protein in CSF:

A

Newborn: 20-120 mg/dl

Infant/Child: 15-45 mg/dl

23
Q

Protein in Bacterial Meningitis:

A

Elevated to 100-150 mg/dl

24
Q

Protein in Viral Meningitis:

A

normal or slightly elevated to 30-100 mg/dl

25
Q

Normal Glucose in CSF:

A

Newborn: 20-40 mg/dl

Infant/Child: 70-90 mg/dl

26
Q

Glucose in Bacterial Meningitis:

A

Decreased 0-15 mg/dl

about 40% of serum glucose

27
Q

Glucose in Viral Meningitis:

A

Normal, about 66% of serum glucose

28
Q

Will viral meningitis have positive bacterial culture?

A

no

29
Q

During the first 24 hrs of antibiotic therapy, we do what?

A

isolate the child

30
Q

What do we monitor for during antibiotic treatment for meningitis?

A

hearing loss if taking aminoglycosides

31
Q

Nursing care for Meningitis

A

Elevate head

Reduce external stimulation

Dark room

Limit visitation