T3 - Meningitis (Josh) Flashcards
What is meningitis?
irritation of meninges of the brain due to a bacterial or aseptic infection
potentially fatal
Patho of meningitis?
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.
What type of position does bacterial meningitis cause?
opisthotonic position,
- neck and head hyperextended, to relieve discomfort.
S/S of Meningitis
Nuchal rigidity
Fever
Lethargy/irritability
Abrupt onset
Poor feeding
Possible complications form Meningitis
DIC
Subdural effusion
Sepsis
Septic Arthritis
Seizures
Hearing Loss
Meningitis S/S look like –
ICP s/s
- Seizures
- Shrill cry
- Vomiting
- Bulging fontanel
Test for which signs w/ Meningitis.
Kernig
Brudzinski
Bacterial meningitis is — of the meninges cause by –
inflammation
release of TNF that initiates the inflammatory process
Which vaccine has decreased risk of bacterial meningitis?
H Influenzae
Clinical manifestations of Meningitis
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)
Sign of Meningitis:
Severe neck stiffness causes the knees to flex when neck is raised
Brudzinski Sign
Sign of Meningitis
Severe hamstring stiffness causes inability of leg to straighten when raised 90 degrees.
Kernig sign
Meningitis Complications
Obstructive hydrocephalus
Subdural effusions, anoxia / cell death
Blindness, deafness, weakness
Meningococcal sepsis- septic shock, DIC, 90% mortality
SIADH, seizures, cerebral edema, herniation
In Meningitis, – is elevated and – is reduced.
Protein
Glucose
How long is isolation for Meningitis?
24 hours
Another sign of Meningitis?
Purpura on skin
Kernig’s Sign
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.
Brudzinski Sign
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.
CSF Appearance:
Normal: clear
Bacterial Meningitis: cloudy, turbulent, purulent
Viral Meningitis: clear or slightly cloudy
CSF Pressure:
Normal: 70-180 mmH2O
Bacterial Meningitis: elevated
Viral Meningitis: normal or elevated
WBC in CSF:
Normal: 0-5, 8, or 15
Bacterial Meningitis: elevated 1000 or more per mm
Viral Meningitis: elevated 500 or more per mm
Normal Protein in CSF:
Newborn: 20-120 mg/dl
Infant/Child: 15-45 mg/dl
Protein in Bacterial Meningitis:
Elevated to 100-150 mg/dl
Protein in Viral Meningitis:
normal or slightly elevated to 30-100 mg/dl
Normal Glucose in CSF:
Newborn: 20-40 mg/dl
Infant/Child: 70-90 mg/dl
Glucose in Bacterial Meningitis:
Decreased 0-15 mg/dl
about 40% of serum glucose
Glucose in Viral Meningitis:
Normal, about 66% of serum glucose
Will viral meningitis have positive bacterial culture?
no
During the first 24 hrs of antibiotic therapy, we do what?
isolate the child
What do we monitor for during antibiotic treatment for meningitis?
hearing loss if taking aminoglycosides
Nursing care for Meningitis
Elevate head
Reduce external stimulation
Dark room
Limit visitation
