Unit 7

Question 1

Describe a positive Brudzinski’s sign.

Answer 1

Pain when the head is up and chin is down.

Question 2

Describe a positive kernigs sign.

Answer 2

Pain when the legs are raised.

Question 3

What age group is most at risk for meningitis and why?

Answer 3

16-21 because outbreaks are most likely to occur in college dorms, military barracks and crowded living areas.

Question 4

What are the pupil reaction and eye movements associated with meningitis?

Answer 4

Photophobia
Nystagmus
Abnormal eye movements

Question 5

What are the motor response changes associated with meningitis?

Answer 5

Hemiparesis, hemiplegia and decreased muscle tone

Cranial nerve dysfunction (3,4,6,7,8)

Question 6

What are the memory changes associated with meningitis?

Answer 6

Short attention span
personality and behavior change
Bewilderment

Question 7

Severe and unrelenting headaches are associated with?

Answer 7

Meningitis

Question 8

Generalized muscle aches and paines
Nausea and vomiting
Fever and chills
Tachycardia
Red macular rash

These are associated with?

Answer 8

Meningitis

Question 9

When can seizures occur for the patient with meningitis?

Answer 9

When meningeal inflammation spreads to the cerebral cortex.

Question 10

What is the most significant lab test that is used to diagnose meningitis?

Answer 10

CSF

Question 11

What do you teach your patient is regards to preventing meningitis?

Answer 11

Get vaccines like Hib, pneumococcal, mumps, varicella and meningococcal organisms.

Question 12

What are the most important nursing interventions for patients with meningitis?

Answer 12

Accurately monitoring and documenting their neurologic status.

Question 13

When caring for a patient with meningitis, what is the priority of care?

Answer 13

ABC’s

Question 14

How often do you take vitals for the patient with meningitis?

Answer 14

Every 2-4 hours.

Question 15

Why is intake and output carefully monitored for the patient with with meningitis

Answer 15

To maintain fluid balance and prevent fluid overload.

Question 16

How do you decrease environmental stimuli when caring for a patient with meningitis?

Answer 16

Provide a quiet environment
Minimize exposure to bright lights from windows and overhead lights
Maintain bedrest with the HOB elevated 30 degrees

Question 17

What type of precautions are put into effect for the patient with bacterial meningitis?

Answer 17

Droplet.

Question 18

How many feet do you need to stay away from a patient with meningitis if you do not have a mask on?

Answer 18

3 feet.

Question 19

What must the patient have on when transporting them outside of the room?

Answer 19

A mask.

Question 20

What five complications are associated with meningitis?

Answer 20

ICP
Vascular disease
Fluid and electrolyte imbalance
Seizures
Shock

Question 21

What type of precautions is appropriate for a patient with viral meningitis?

Answer 21

Standard precautions

Question 22

What can a 6th cranial nerve defect indicate?

Answer 22

Hydrocephalus

Question 23

What drugs are used to treat meningitis?

Answer 23

Broad spectrum antibiotic until culture and gram stain results are available.
Mannitol

Question 24

Which drugs are given to people who have been in close contact with a patient with N. meningitits?

Answer 24

Rifampin
Ciprofloxacin
Ceftriaxone

Question 25

An inflammation of the brain tissue and often the surrounding meninges is known as?

Answer 25

Encephalitis

Question 26

What are the most common cause of encephalitis?

Answer 26

Eastern and western encephalitis California encephalitis West Nile virus

Question 27

What are the signs and symptoms associated with meningitis?

Answer 27

``` Nuchal rigidity Photophobia Phonophobia Headache Myalgia Nausea and vomiting ```

Question 28

``` Changes in mental status Motor dysfunction Focal neurologic deficits Photophobia Fatigue Symptoms of ICP Joint pain Headache Vertigo ``` These manifestations are associated with?

Answer 28

Encephalitis

Question 29

How is encephalitis diagnosed?

Answer 29

Lumbar puncture

Question 30

What is the drug of choice for encephalitis?

Answer 30

Acyclovir

Question 31

What would prevent elevation of HOB in the patient with encephalitis?

Answer 31

Post lumbar puncture | Severe hypotension

Question 32

What vital sign changes must be told to the HCP for a patient with encephalitis?

Answer 32

Widened pulse preasure New bradycardia Irregular respiratory effort Dilated and unresponsive to light pupils

Question 33

Protecting the patient and family from West Nile Virus: | When time outside should be limited.

Answer 33

Between dusk and dawn when mosquitos are out.

Question 34

Protecting the patient and family from West Nile Virus: | What type of clothing should be worn?

Answer 34

Protective clothing, including long sleeves and pants.

Question 35

Protecting the patient and family from West Nile Virus: | What type of insect repellent is recommended ?

Answer 35

DEET

Question 36

An upper and lower motor neuron disease of adult onset is known as?

Answer 36

ALS

Question 37

How is ALS characterized?

Answer 37

Progressive weakness Muscle wasting Spasticity that eventually leads to paralysis

Question 38

What age group is commonly affected by ALS?

Answer 38

People 40-60 years of age

Question 39

Which gender is affected more by ALS?

Answer 39

Men

Question 40

What is the most common cause of death in regards to the patient with ALS?

Answer 40

Respiratory failure.