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Flashcards in Meningitis Deck (36):
1

What is the definition of meningitis?

Inflammation of the meninges of the brain

2

What are the 3 types of meningitis?

Bacterial, Viral, Tuberculous

3

What are causative agents of meningitis?

Streptococcus pneumoniae and Neisseria, Group B strep., e. coli, listeria

4

What type of transmittable disease is meningitis?

Droplet

5

What type can the baby be infected from from the mother?

Group B.

6

How does bacterial meningitis start?

As an upper respiratory infection, then initiates swelling of meninges

7

What is the incidence of meningitis?

Can occur at any time- flu is in the autumn/winter, pneumococcal and meningicoccal late winter and spring

8

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

9

Where does the purulent exudate extend to?

The 4 ventricles

10

What does the thick pus, fibrin and adhesions obstruct?

The flow of CSF through the aqueduct of Sylvius

11

What does the aqueduct of sylvius do?

connects the midline ventricles

12

What are classic symptoms of meningitis?

Severe headache, dislike bright lights, fever, projectile vomitting, stiff neck, rapid breathing, drowsy, stomach, joint, muscle pains, rash

13

What are early signs of meningitis?

Pale, blue, dusky skin around lips, severe leg pain, cold hands or feet, high temperature

14

What are clinical manifestations in infants and young children of bacterial meningitis?

fever, vomitting, poor feeding, irritability, seizures, buldging fontanels, stiff neck, rash

15

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

16

What is Kernig's Sign?

Positive sign means they cannot straighten their leg because of how stiff the hamstring is

17

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

18

How is bacterial meningitis diagnosed?

By Lumbar puncture, sometimes blood and nasal cultures

19

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

20

What type of isolation is the child on?

Respiratory- droplet and contact procautions

21

What are some therapeutic management techniques?

maintain hydration and ventilation, reduce ICP, manage shock, control seizures and temperature, correct anemia

22

What is a normal ICP?

5-15mmHG

23

What types of drugs would be used to treat bacterial meningitis?

Antibiotics- 10 days, rocephin, cefotaxine, vancomycin
Steroids- Dexamethosone
Headache- Acetaminophen
Antipyretics- Hydrate and acetaminophen

24

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

25

What are some complications of bacterial meningitis?

hydrocephalus, subdural effusion, thrombosis in meningeal veins, brain abscess, deafness, blindness, weakness, paralysis of face/neck

26

What is SIADH?

Hyponatremia and excessive release of the antidiuretic hormone-- make the brain retain fluid, needa hypertonic solution and loop diuretic

27

What are signs and symptoms of SIADH?

Water retention, lethargy, coma, seizures, nausea, vomitting, electrolyte imbalance, edema

28

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)

29

What is DIC?

Deceminated Intravascular Cementation- the blood is unable to clot- treat with heparin to stop the cascade

30

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

31

How do you prevent bacterial meningitis?

Treat infections immediately, keep up with immunizations, rifampin to those exposed

32

What is viral meningitis?

Inflammation of the meninges associated with past exposure to measles, mumps, herpes, leukemia, and enteroviruses

33

What is the pathophysiology of viral meningitis?

Caused by enteroviruses from sputum, saliva, or mucousa with spontaneous subsiding of symptoms with no residual effects

34

Clinical manifestations of viral meningitis

Same as bacterial, different kind of rash

35

How do you diagnose viral meningitis?

Lumbar puncture- differentiates between bacterial and viral- negative bacterial culture

36

How do you treat viral meningitis?

Treat symptoms- self limiting disease. Decrease stimulu, control fever, hydrate, antibiotics until viral is confirmed