Meningitis & Liver Flashcards
The nurse is admitting a patient experiencing photophobia and nuchal rigidity secondary to potential meningitis. The nurse correlates that findings from which diagnostic test will best confirm this diagnosis?
Lumbar puncture - Examination of cerebrospinal fluid via lumbar puncture is the hallmark for the diagnosis of meningitis
A patient comes to the clinic for headaches. He is irritable and impatient to receive treatment but is alert and oriented, speech is clear, and he is able and willing to answer the nurse’s questions. Which questions will the nurse ask to solicit additional relevant information about this patient’s headaches?
When do the headaches occur?
How often do the headaches occur?
Can you point to the place where your head hurts the worse?
Do you experience other symptoms with the headaches?
Have there been any recent changes in your headaches?
The patient reports neck stiffness, light sensitivity, noise sensitivity, headache, muscle aches, nausea, vomiting, and feeling foggy and kind of out of it. Although the nurse recognizes that all vital signs are important, which question is the nurse MOST LIKELY to ask to assist the health care provider to determine the diagnosis?
Have you had fever or chills?
The nurse is planning care for a patient with meningitis. What teaching material does the nurse prepare to explain prescribed treatments for this disorder?
Long-term antibiotic therapy
Treatment for meningitis generally requires 14 to 21 days of antibiotic treatment. Long-term intravenous access such as a peripherally inserted central line or other central venous access is typically initiated because of the need for long-term antibiotic therapy.
A patient with meningitis is prescribed a cooling blanket. Which explanation does the nurse provide to the patient regarding this treatment?
Decreases oxygen demand in the brain
Controlling a fever with a cooling blanket decreases metabolic activity and decreases central nervous system oxygen demand.
The nurse monitors for which clinical manifestations of increased intracranial pressure in the patient diagnosed with a brain tumor?
Ataxia
Papilledema
Vomiting
Headache
Clinical manifestations of increased ICP include papilledema, headache, nausea and vomiting, decreased alertness, cognitive impairment, personality changes, ataxia, hemiparesis, abnormal reflexes, and cranial nerve palsies.
Papilledema
Papilledema refers to the swelling of both optic discs in your eyes due to increased intracranial pressure (intracranial hypertension).
Ataxia
Impaired balance or coordination, can be due to damage to brain, nerves, or muscles.
Impaired coordination can have causes that aren’t due to underlying disease. Examples include drug or alcohol intoxication.
Hemiparesis
Paralysis of one side of the body
Opisthotonos
A dramatic abnormal posture due to spastic contraction of the extensor muscles of the neck, trunk, and lower extremities that produces a severe backward arching from neck to heel. In most cases, the trunk is elevated off the ground by a few inches.
A patient recovering from a lumbar puncture rates a headache as being 8 on a pain scale of 0 to 10. What action by the nurse is indicated?
Encourage increasing oral fluid intake
The bed should be flat to prevent the onset or worsening of a headache.
The patient should be on bedrest for 4 to 6 hours.
To avoid post–lumbar puncture headaches, ask the patient to stay hydrated postprocedure.
Massaging the lower spine will not help reduce a spinal headache.
Which people should be advised to get the meningococcal vaccine?
Healthy 12-year-old school child
25 yr. old who had a splenectomy due to an auto accident
Healthy 18 yr. old who has enlisted in the military
Healthy 20 yr. old who is planning to live in a university dormitory
Healthy 22 yr. old who is unsure about vaccination status and plans to go to Asia
The nurse is caring for a patient who was admitted for a diagnosis of meningococcal meningitis. Which nursing action is specific to this type of meningitis?
Placing the patient in isolation per hospital procedure
The nurse is reviewing the electrolyte values for a patient with bacterial meningitis and notes that the serum sodium is 126 mEq/L. How does the nurse interpret this finding?
Evidence of syndrome of inappropriate antidiuretic hormone, which is a complication of bacterial meningitis
A patient with meningitis reports a headache, and the nurse gives the appropriate IV push medication. Several hours later, the patient reports pain in the left hand; the radial pulse is very weak, the hand feels cool, and capillary refill is sluggish compared to the left. What does the nurse suspect is occurring in this patient?
Thrombotic or embolic complication causing vascular compromise
A patient arrives in the emergency department reporting headache, fever, nausea, and photosensitivity. The patient has been living with two people who were diagnosed with meningitis. Which diagnostic test does the nurse anticipate the health care provider will order to rule out meningitis?
Lumbar puncture
