Pathophys/Etiology
This condition is an acute inflammation of the brain.
What is encephalitis.
Learning note: Meningitis is inflammation of the meninges surrounding the brain and spinal cord.
This test verifies meningitis by analyzing CSF.
What is a lumbar puncture.
Fever, severe headache, and nuchal rigidity are classic signs of this condition.
What is meningitis.
Treatment for hyperthermia (name two).
BONUS QUESTION (500 pts): Should fever be aggressively managed in these clients?
What are acetaminophen (Tylenol) and aspirin (ASA).
BONUS: Yes, hyperthermia can increase cerebral edema, increasing ICP, risk for seizures, and risk for brain damage.
CAUTION - AVOID shivering (reducing fever too rapidly can cause shivering which increases ICP)
Client positioning in bed to reduce ICP.
What is elevating the head of the bed. Also, extreme avoid hip flexion (knee to chest) and extreme neck flexion (chin to chest)
What is the most common type of meningitis.
What is viral meningitis.
Elevated neutrophils in CSF suggest this type of meningitis.
What is bacterial meningitis. (Viral meningitis would have increased lymphocytes).
This symptom causes discomfort with exposure to light.
What is photophobia.
These drugs are started immediately when meningitis is suspected.
What are IV antibiotics.
Education topics to prevent encephalitis (name one).
What are mosquito and tick control, includes: cleaning rain gutters, removing standing water (bird baths, ponds etc), use of insect repellant, and wearing clothing that fully covers the skin.
Brain abscesses most commonly result from direct extension of infection from these areas (list at two).
What are the ears, sinuses, teeth, or mastoid process?
Diagnostic test that should be completed PRIOR to a lumbar puncture for a client with suspected meningitis.
What is a head CT. (assess for contraindications to lumbar puncture related to potential brain herniation)
ALOC, confusion, and seizures indicate this dangerous complication.
What is increased intracranial pressure (ICP)?
This drug class is considered first‑line treatment for HSV encephalitis.
What are antivirals. (examples include acyclovir, valcyclovir, famciclovir)
Two nursing considerations for a client with left-sided hemiplegia.
What are q2h turns, frequent skin assessments, ROM, fall risk precautions, or assisting with ADLs.
Populations most at risk for meningitis infection.
What is populations living in close quarters (college dormitories, prisons/jails, etc).
A non‑blanching rash with petechiae suggests infection with this organism for a client with meningitis.
What is meningococcal meningitis. (use a "tumbler" test to see if rash does not blanch.)
Client states, "I’m seeing two of everything instead of one".
What is diplopia.
Antiseizure medication commonly used in meningitis (name one).
What is phenytoin (Dilantin) or levetiracetam (Keppra).
This type of isolation is required for meningococcal meningitis.
What is respiratory isolation.
Potential cause of nonepidemic encephalitis (name one).
What is herpes simplex virus (HSV), measles, mumps, chickenpox, or cytomegalovirus (CMV).
What lab tests should be completed prior to initiating antibiotics for client with suspected bacterial meningitis (name two)?
What are blood cultures, sputum cultures, or CSF culture.
The client has weakness on the RUE and RLE.
What is right-sided hemiparesis.
This analgesic provides headache relief without heavy sedation.
What is codeine.
Nursing care for photophobia.
What is a dark room and/or cool compress over the eyes.
This organism once caused most cases of bacterial meningitis but declined due to vaccination.
What is Haemophilus influenzae? (prevented by HIB vaccine)
This test detects viral DNA or RNA and is highly sensitive for CNS infections.
What is PCR.
The client states: "It feels like my vision is cut in half" and "I only eat the food on one side of my plate".
What is hemianopsia (loss of half of the visual field).
This steroid may be given to reduce brain inflammation and reduce ICP.
What is dexamethasone.
Nursing assessment to monitor for development of SIADH or diabetes insipidus in a client with increased ICP.
What is intake and output.
SIADH = minimal urine output
Diabetes insipidus = excessive urine output