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Fundamentals SEM3 > WEEK 5 (peds neuro) > Flashcards

WEEK 5 (peds neuro) Flashcards

Meningitis and Reye's syndrome (51 cards)

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1
Q

define meningitis

A

serious and life-threatening medical condition

caused by inflammation of the meninges due to viruses, bacteria, and fungi

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2
Q

what infectious agent and cause meningitis?

A

viruses
bacteria
fungi

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3
Q

Most cases of meningitis are caused by an

A

infectious agent that has colonized or established a localized infection elsewhere in the host.

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4
Q

risk factors for meningitis are separated into what two categories?

A

viral and bacterial

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5
Q

risk factors for meningitis: viral (5)

A

cytomegalovirus
herpes simplex virus
enterovirus
HIV
arbovirus

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6
Q

risk factors for meningitis: bacterial (3)

A

infections by bacterial agents
injuries provided direct access to CSF
crowded living conditions

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7
Q

what are some signs and symptoms of meningitis

A

photophobia
vomiting
irritability
headache

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8
Q

what is the classic triad for meningitis?

A

fever
headache
neck stiffness

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9
Q

assessment: signs and symptoms of meningitis in a peds patients of 3 months- 2 years old

A

seizures
high-pitched cry
fever
irritability
bulging fontanels
possible nuchal rigidity
poor feeding
vomiting
Brudzinki’s sign
Kernig’s sign

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10
Q

positive Brudzinski sign

A

Severe neck stiffness causes a patient’s hips and knees to flex when the neck is flexed

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11
Q

positive Kernig’s sign

A

When the patient is lying with the thigh flexed on the abdomen, the leg cannot be completely extended.

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12
Q

what age is Kernig and Brudzinski sign go with for meningitis

A

age 3 months to 2 years

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13
Q

is a positive Kernig’s and/or Brudzinski sign a positive indicator for meningitis for age 3 months to 2 years

A

no

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14
Q

assessment: signs and symptoms of meningitis of peds patients for age 2 years to adolescents

A

seizures (INITIAL)
Nuchal rigidity
Brudzinski’s Sign
Kernig’s Sign
Fever & chills
Headache
Vomiting
Irritability & restlessness
Drowsiness, delirium, stupor, & coma
Petechiae or purpuric-type rash
Joint involvement
Ear drainage

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15
Q

what is the initial sign of meningitis for a peds patient age 2 years to adolescent age?

A

seizures

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16
Q

Labs and Dx for meningitis

A

blood cultures
CBC
CSF analysis
lumbar puncture
CT scan
MRI

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17
Q

CSF analysis for bacterial infection results (5 things)

A

Cloudy,
High WBC,
High Protein,
Low Glucose,
+ Gram Stain

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18
Q

CSF analysis for viral infection results (5 things)

A

Clear
High (slightly) WBC,
Normal – Slightly High Protein,
Normal Glucose,
- Gram Stain

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19
Q

complication of meningitis

A

increased ICP

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20
Q

signs and symptoms of rising ICP in newborns and infants

A

bulging or tense fontanels, increased head circumference, high-pitched cry, distended scalp veins, irritability, bradycardia, respiratory changes

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21
Q

signs and symptoms of risking ICP in children

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A

increased irritability, headache, nausea, vomiting, diplopia, seizures, bradycardia, respiratory changes

22
Q

Provide interventions to reduce ICP (meningitis)

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A

Positioning, avoidance of coughing, straining, decrease bright lights, minimize environmental stimuli

23
Q

take action for meningitis (precautions)

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A

isolation
droplet precautions
respiratory isolation

24
Q

implementation: meningitis (monitoring…6 things)

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A

VS
Urine output
Fluid status
Pain level
Neurologic status
Head circumference / fontanels

25
implementation: medications for meningitis
antibiotics corticosteroids analgesics
26
antibiotics for meningitis (what to assess, education, etc)
IV ATB for bacterial infections Assess for allergies Provide support Educate Complete entire course
27
treatment for meningitis: corticosteroids (which one?)
Dexamethasone
28
Dexamethasone (meningitis) why is it given
indicated for bacterial infection initial given for increased ICP reduction of neuro complications
29
treatment of meningitis: analgesics (which one?)
acetaminophen with codeine
30
acetaminophen with codeine (meningitis): why is it given what to monitor
Relieves discomfort Assess temperature Monitor respiratory status Monitor LOC
31
meningitis: maintain immunizations
Hib and PCV Vaccines Ages 2, 4, 6 months between 12-15 months
32
define: Reye syndrome
a rare but potentially life-threatening condition that primarily affects children and young adults recovering from viral infections and is characterized by acute brain and liver inflammation
33
what does Reye syndrome primarily affects
liver and brain
34
when does peak incidence of Reye syndrome peak with?
influenza times
35
Reye syndrome: prognosis is best with...
early diagnosis and treatment
36
the causes of Reye syndrome are divided into two categories
pathogens and salicylates
37
causes of Reye's syndrome: pathogens
flu A & B varicella-zoster virus
38
causes of Reye's syndrome: salicylates
aspirin
39
slide 20: risk factors for Reye's syndrome
ASA use with viral infection typically follows a viral illness
40
signs and symptoms of Reye's syndrome
lethargy irritability combativeness confusion delirium profuse vomiting seizures loss of conciousness
41
Labs and Dx: Reye's syndrome
liver enzymes blood ammonia blood electrolytes coagulation times liver biopsy CSF analysis
42
Reye's syndrome: ALT and AST
increase 3 times normal but may return by stages 4 to 5
43
Reye's syndrome: bilirubin
higher than 2 mg/dL
44
Reye's syndrome: ammonia levels
as high as 1.5 times normal after mental status change is the most frequent lab abnormality
45
most frequently seen lab abnormality with Reye syndrome
high ammonia levels
46
Reye's syndrome: PT and aPTT
prolonged more than 1.5-fold
47
Reye's syndrome: CSF analysis
if patient is stable, lumbar puncture will show slight increase in WBCs in the CSF
48
TAKE ACTIONS: NURSING CARE (Reye's syndrome)
Maintain hydration Positioning Monitor coagulation Prevent hemorrhage Assess / Monitor pain Assist with ventilation / intubation Implement seizure precautions Education / inform family Provide family time if death is imminent Initiate referrals
49
medications (implementation): Reye's syndrome class name what does it do monitor what
osmotic diuretic: mannitol intention: decreases cerebral swelling monitor: for increased ICP
50
interprofessional care: Reye's syndrome
OT/PT/dietitian
51
implementation: education (Reye's syndrome)
no salicylates for pain or fever in children! read OTC labels liver function usually returns neurological function usually persists

Fundamentals SEM3 (6 decks)

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