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What are the s/s meningitis in adults?
- severe headache 90% common
- nuchal rigidity
- sudden high fever
- altered mental status, confusion
- nuchal rigidity -inability to flex neck forward passively due to increased neck muscle tone & stiffness, occurs in 70% of cases
- photophobia (intolerance to bright light) and
- phonophobia (intolerance to loud noises).
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What are the s/s meningitis in children?
- Nery non-specific!
- Drowsiness
- May be irritable and looking unwell
- Bulging of the fontanelle (up to 6 mo)
- Leg pain, cold extremities
- Characteristic rash
- Rash numerous small, irregular purple or red spots ("petechiae") on the trunk, lower
- extremities, mucous membranes, conjuctiva, It is specific for the disease;
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Wht are the long term consequesnces of meningitis? #3
- deafness, epilepsy,
- hydrocephalus and cognitive deficits,
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Treatment of meningitis?
- Lumbar puncture
- Antibiotics
- Antivirals drugs
- Corticosteroids
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What is petechiae? #6
A is a small (1-2mm) red or purple spot on the body, caused by a minor hemorrhage (broken capillary blood vessels).
Used to refer to the smallest of the three classes of purpuric skin eruptions, those that measure less than 3 mm.
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What is Malaise?
- Feeling of general discomfort or uneasiness
- General feeling of being unwell
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What is the pupillary light reflex?
- Both pupils should constrict with light shone into either eye alone.
- Optic nerve damage
- Oculomotor nerve damage
- Brain stem death
- Depressant drugs (barbiturates)
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Stroke Who calls neurology when stroke pt arrive?
ED MD
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When do we give (protocol) Stroke medication?
What is it?
- MD must order Alteplase
- Pharmacy will come to the ED to mix at bedside & give to RN
- Must be given within < 3 hrs
- Door to Alteplase <60 min
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How do you perform swallow sceen?
90 ml of water
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Misc.
send labs withing 15 min
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When to realease orders for boarder pts?
- release meds at 2 hrs
- release everything else at 4 hrs
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