1. Meningitis
    • inflammation of meniges that surround the brain and spinal cord
    • it spreads rapidly cause of CSF circulation around the brain and spinal cord
  2. types of meningitis
    • bacterial (pyogenic/septic)
    • - n. meningitis (menigococcal)
    • - streptococcal
    • - in close contact, spread by droplets, upper airway
    • viral (aspetic)
    • - measels, mumps
    • fungal/protozoal
    • - immunodeficiency, HIV, chemo etc
  3. risk factors for meningitis
    • crowded, dense living setting- college
    • URI, sinus infe- viral molecules spread
    • ear infections, mastoiditis
    • impaired immune system (HIV, chemo)
    • trauma
    • invasive procedure- involving the upper airway, nose
  4. patho bacterial viral
    • organism enters in bloodstream at Blood brain barrier
    • produces an inflammatory response- incr cap perm
    • - pia and arachronoid mater
    • - csf
    • - ventricles
    • exudate can cause congestion, infarction (dec blood supply)
    • - no exudate in viral- less likely to have long term effects
    • meninges thicken, adhension form- damage cranial nerve
    • blockage of CSF outflow, incr ICP and futher neruological damage
    • - impacts brain tissue
  5. differences between bacteria and viral meningitis
    look over slides
  6. clinical manifestation of meningitis
    • Headache, fever (meningal irritation)
    • painful, stiff neck (nuchal rigidity)
    • photophobia
    • + Kernig sign- can't extend leg, knee is bent
    • + brudzinski's sign- flex head and knees come up
    • rach (petechial- ecchymosis)
    • chx in orientation and memory- secondary to inc iCP, 8th CN balance
    • lethargy
  7. more clinical manifestation of meningitis
    • seizures r/t brain swelling
    • as illness progresses lethargy, unresponsiveness
    • s/s of ICP - wide pulse pressure, dec HR, de rr, chx in pupillary response
    • coma as a result of brain stem herniation
  8. Kernig
    resistance to extension or straightening of the knee while the person is lying with the hip flexed at a right angle
  9. Brudzinki's sign
    the sign is elicited when flexion of the neck induces flexion of the hip and knee
  10. diagnosis of bacterial meningitis
    • history and physical exam
    • CBC w/diff blood culure
    • CAT scan (non contrast) or MRN do this b4 the LP to check of ICP. you don't want to cause brain herniation
    • lumbar puncture (CSF analysis)
    • review LP care
  11. Nursing management
    • collaboration with other health team members
    • provide comfort, quiet dark room
    • continual neurological and VS assessment- incre ICP
    • maintain droplet precautions for the 1st 24 hours
    • monitor daily weight and labs- seizure drugs based on wt
    • maintain integrity- petechial rash
    • maintain fluid balance- IV
    • medicate with antibiotics, antiseizure meds, and analgesics (tylenol for h/a)- IV
    • strategic coping pans for the fam
    • educate family
    • prevention- menigococcal vaccine and h. influenza, pneumonia
    • decadron (solumetrol)- given with antibiotic for a synergistic effect- makes the med work better- this is a steriod
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