Flashcards in Meningitis Deck (36):
What is the definition of meningitis?
Inflammation of the meninges of the brain
What are the 3 types of meningitis?
Bacterial, Viral, Tuberculous
What are causative agents of meningitis?
Streptococcus pneumoniae and Neisseria, Group B strep., e. coli, listeria
What type of transmittable disease is meningitis?
What type can the baby be infected from from the mother?
How does bacterial meningitis start?
As an upper respiratory infection, then initiates swelling of meninges
What is the incidence of meningitis?
Can occur at any time- flu is in the autumn/winter, pneumococcal and meningicoccal late winter and spring
What is the pathophysilogy of bacterial meningitis?
Starts as inflammation, then exudation, then white blood cells are accumulated and tissue damage can occur-- the brain becomes hyperemic and edematous
Where does the purulent exudate extend to?
The 4 ventricles
What does the thick pus, fibrin and adhesions obstruct?
The flow of CSF through the aqueduct of Sylvius
What does the aqueduct of sylvius do?
connects the midline ventricles
What are classic symptoms of meningitis?
Severe headache, dislike bright lights, fever, projectile vomitting, stiff neck, rapid breathing, drowsy, stomach, joint, muscle pains, rash
What are early signs of meningitis?
Pale, blue, dusky skin around lips, severe leg pain, cold hands or feet, high temperature
What are clinical manifestations in infants and young children of bacterial meningitis?
fever, vomitting, poor feeding, irritability, seizures, buldging fontanels, stiff neck, rash
What are clinical manifestations in older children and teens of bacterial meningitis?
fever, chills, severe headache, vomitting, stiff neck, Kernigs and Brudzinski's signs, rash, photophobia, seizures
What is Kernig's Sign?
Positive sign means they cannot straighten their leg because of how stiff the hamstring is
What is Brudzinski's Sign?
Positive is when the neck is stiff and they have to flex their knees and hips to flex their neck
How is bacterial meningitis diagnosed?
By Lumbar puncture, sometimes blood and nasal cultures
Nursing responsibilities for lumbar puncture
Keep back curved, keep child still, lay them on their side or sit upright, keep the field sterile- then comfort them after, teach parents about the procedure before
What type of isolation is the child on?
Respiratory- droplet and contact procautions
What are some therapeutic management techniques?
maintain hydration and ventilation, reduce ICP, manage shock, control seizures and temperature, correct anemia
What is a normal ICP?
What types of drugs would be used to treat bacterial meningitis?
Antibiotics- 10 days, rocephin, cefotaxine, vancomycin
Antipyretics- Hydrate and acetaminophen
Bacterial meningitis treatment in the hospital
Maintain ventilation, monitor respiratory status, keep room quiet, dark, no noise, control seizures, administer meds- AVOID NARCOTICS, neuro assessment, strick I&O, measure head circumference
What are some complications of bacterial meningitis?
hydrocephalus, subdural effusion, thrombosis in meningeal veins, brain abscess, deafness, blindness, weakness, paralysis of face/neck
What is SIADH?
Hyponatremia and excessive release of the antidiuretic hormone-- make the brain retain fluid, needa hypertonic solution and loop diuretic
What are signs and symptoms of SIADH?
Water retention, lethargy, coma, seizures, nausea, vomitting, electrolyte imbalance, edema
What is waterhouse-Friderichsen syndrome?
Sudden, rapid, severe onset of overwhelming septic shock, causes DIC and massive bilateral adrenal hemorrhage and purpura (usually with Nisseria)
What is DIC?
Deceminated Intravascular Cementation- the blood is unable to clot- treat with heparin to stop the cascade
What are some residual effects of complications related to bacterial meningtis?
Seizure disorders, hearing loss, vision loss, mental retardation, cognitive delays, may need a ventricular peritoneal shunt
How do you prevent bacterial meningitis?
Treat infections immediately, keep up with immunizations, rifampin to those exposed
What is viral meningitis?
Inflammation of the meninges associated with past exposure to measles, mumps, herpes, leukemia, and enteroviruses
What is the pathophysiology of viral meningitis?
Caused by enteroviruses from sputum, saliva, or mucousa with spontaneous subsiding of symptoms with no residual effects
Clinical manifestations of viral meningitis
Same as bacterial, different kind of rash
How do you diagnose viral meningitis?
Lumbar puncture- differentiates between bacterial and viral- negative bacterial culture