Meningitis Flashcards

1
Q

What is meningitis?

A

Inflammation of the membranes and the fluid space surrounding the brain and spinal cord

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2
Q

What are different types of meningitis?

A

Bacterial (septic) meningitis
* Neisseria meningitidis** [most common]**
* Haemophilus influenzae
* Streptococcus pneumoniae)

Viral (aseptic) Meningitis owing to viral infection, lymphoma, leukemia, neurosurgical procedures, or brain abscess

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3
Q

What is the most common cause of bacterial meningitis?

A

Neisseria meningitidis

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4
Q

What is the triad of symptoms associated with meningitis?

A

Fever
Headache
Nuchal Rigidity
* Kernig’s Sign
* Brudzinski’s Sign

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5
Q

Aside from the triad of symptoms characteristic of meningitis (fever, headache, nuchal regidity), what are other symptoms?

A

Photophobia
Phonophobia
Lethargy

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6
Q

Generally, how is meningitis diagnosed?

A

Cerebrospinal Fluid (CSF) Analysis via Lumbar Puncture

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7
Q

What are characteristics of bacterial meningitis?

A
  • Acute inflammation of meningeal tissue
  • A medical emergency.
  • Organisms enter CNS from respiratory tract or bloodstream.
  • Increased CSF production
  • Purulent secretions spread to other areas of brain through CSF.
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8
Q

What are clinical manifestations of bacterial meningitis?

A

Fever
Severe headache
Nausea, vomiting
Nuchal rigidity
- Positive Kernig’s sign
- Positive Brudzinski’s sign
Photophobia
↓ LOC
Signs of ↑ ICP*
Coma
Seizures*

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9
Q

What are complications of bacterial meningitis?

A

Acute complication is ↑ ICP.
Major cause of unconsciousness
Residual neurological dysfunction*
Optic nerve is compressed by increased ICP.
Hemiparesis, dysphagia, and hemianopsia
Acute cerebral edema
Noncommunicating hydrocephalus
Waterhouse-Friderichsen syndrome

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10
Q

How is bacterial meningitis diagnosed?

A

Blood culture
Lumbar puncture and analysis of CSF - Gram-stained smear to detect bacteria
X-rays of skull
CT scan
MRI

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11
Q

What is involved in the collaborative care of a client with bacterial meningitis?

A
  • Rapid diagnosis based on history and physical exam
  • Antibiotic therapy instituted after collection of specimens
  • Collaborate to manage the headache, fever, and nuchal rigidity
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12
Q

What are characteristics of viral meningitis?

A
  • Most common causes are enterovirus, arbovirus, HIV, and HSV.
  • Usually presents as headache, fever, photophobia, and stiff neck
  • Diagnostic testing of CSF
  • Lymphocytosis
  • No organisms from Gram-stained or acid-fast smears
  • PCR to detect viral-specific DNA/RNA
  • Symptomatic management with full recovery expected
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13
Q

What is involved in nursing management of meningitis?

A

Frequent or continual assessment
Protect patient from injury (seizure precautions)
Fluid Balance
- Daily weight, serum electrolytes, urine volume, specific gravity, and osmolality
Mobility
- Prevent complications associated with immobility
Infection control
Supportive care
Psychosocial
- Implement measures to facilitate coping of the patient and family

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14
Q

What is a common way that bacterial meningitis is spread?

A

Can spread in community living situations (such as students in dorms)

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15
Q

What is the difference in cerebrospinal fluid between bacterial and viral meningitis?

A

CSF is cloudy in bacterial, clear in viral

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16
Q

When is bacterial meningitis most prevalent in terms of seasons?

A

Winter and early spring

17
Q

What are some signs for the nurse to watch for in terms of elevated ICP?

A
  • changed level of consciousness
  • vision changes
  • BP (increases)
  • pupillary response
  • headache
18
Q

What is the best way to prevent meningitis?

A
  • Vaccination
  • Antiobiotics prophylactically with exposure
19
Q

What level of white blood cell count in 1 uL of CSF usually means meningitis?

A

> 5

20
Q

What happens to pressure, glucose and proteins in the CSF with meningitis?

A
  • Pressure increases
  • Glucose concentration decreases
  • Protein levels increase
21
Q

What factors can increase the risk for bacterial meningitis?

A
  • tobacco use
  • otitis media
  • mastoiditis
  • immune system deficiencies
22
Q

What causative agents lead to acute meningitis?

A

bacterial and viral meningitis

23
Q

What causative agent causes chronic meningitis?

A

fungi

24
Q

Which bacteria can cause bacterial meningitis?

A
  • Group B streptococci
  • E. coli
  • listeria monocytogenes
  • neisseria meningitidis
  • streptococcus pneumoniae
  • Tick borne: borrelia burgdorferi
25
Q

Which viruses can cause viral meningitis?

A

More common:
enterovirus
arbovirus
herpes simplex
HIV

Less common:
mumps
varicella zoster
lymphocytic choriomeningitis

26
Q

What treatment is common for bacterial meningitis?

A

Steroids, then antibiotics. Steroids are to address inflammation and prevent injury to the leptomeninges.

27
Q

What can be done to prevent outbreaks of bacterial meningitis?

A

prophylactic antibiotics
(vaccination may be appropriate as well depending on age group)

28
Q

What type of precaution is put in place for suspected or confirmed meningitis?

A

Droplet precautions
Also, seizure precautions