Flashcards in ATI Unit 2 Meningitis Deck (11):
what is meningitis?
- an infection of the meninges, the protective layers surrounding the brains; most are viral (or asceptic) and resolve on their own; fungal happens in AIDs patients
- bacterial is the most dangerous and their are 3 strains of meningitis vaccines. one specifically for college dorm students (think overcrowded, comorbidity, infection of lungs ENT)
Note: use insect repellant when risk of being bit by mosquito exists
what are the three meningitis vaccines?
1) Haemophilus influenza type B (Hib) vaccine - infants, should be on schedule
2) Pneumococcal polysaccharide vaccine (PPSV) - immunocompromised, chronic disease, older, smokers, in long-term care
3) Meningococcal vaccine (MCV4) - Neiseria meningitis usually for college, military, etc
what is the vaccine against viral meningitis?
there is none, includes mumps, measles, herpes, and arboviruses (West Nile)
symptoms of meningitis?
- altered mental states
- infection stuff
- positive Kernig's (resistance/pain with extension of leg from flexion) and Brudzinski's Sign (flexion of extremities with deliberate flexion of neck)
- red, macular rash
what's the most definitive test for meningitis?
CSF analysis post-lumbar puncture
- analysis includes
Color of CSF
1. cloudy (bacterial)
2. clear (viral)
3. decreased glucose (bacterial)
4. elevated WBC and protein and CSF pressure
what precautions are a patient with menigiitis under?
droplet + standards
- keep until antibiotics have at least been started for 24 hours
care for patient with meningitis
1) cool blanket
2) decrease stimuli
3) raise bed (ICP) - avoid coughing/sneezing
4) provide emesis basin b/c of NV
5) monitor for tachycardia
if the ICP increased in a patient with meningitis, what could you anticipate giving and why?
anticonvulsant like dilantin (phenytoin) b/c of seizures
ceftriaxone (Rocephin) or cefotaxime (Claforan) in combo with vanocin (Vancomycin).
ciprofloxacin (Cipro), rifampin (Rifadin), or ceftriaxone (Rocephin)
--- what are these different sets for in relation for meningitis
- combo with vanco = treatment
- cipro, rifampin etc = prophylactic
Complications of meningitis
1) Increased ICP and poss herniation
- signs: decreased LoC, pupillary changes, impaired ocular movements, hypertension
- positioning and avoid coughing/sneezing
- admin mannitol IV
2) SIADH (diluted blood, hypokalemia, hypocalcemia, hypernatremia, concentrated urine)
- admin demeclocycline
3) Septic emboli
- can cause gangrene