Meningitis is a clinical syndrome characterized by inflammation of the meninges, the three layers of membranes that enclose the brain and spinal cord. Show
What is Meningitis?Infections of the central nervous system (CNS) can be divided into two broad categories: those primarily involving the meninges (meningitis; see the image below) and those primarily confined to the parenchyma (encephalitis). Meningitis is a clinical syndrome characterized by inflammation of the meninges, the three layers of membranes that enclose the brain and spinal cord. These layers consist of the following:
Anatomically, meningitis can be divided into inflammation of the dura (sometimes referred to as pachymeningitis), which is less common, and leptomeningitis, which is more common and is defined as inflammation of the arachnoid tissue and subarachnoid space. PathophysiologyMost cases of meningitis are caused by an infectious agent that has colonized or established a localized infection elsewhere in the host.
Statistics and IncidencesThe incidence of meningitis varies according to the specific etiologic agent, as well as in conjunction with a nation’s medical resources.
CausesCauses of meningitis include bacteria, viruses, fungi, parasites, and drugs (eg, NSAIDs, metronidazole, and IV immunoglobulin [IVIg]).
Clinical ManifestationsOnly about 44% of adults with bacterial meningitis exhibit the classic triad of fever, headache, and neck stiffness.
Assessment and Diagnostic FindingsThe diagnostic tests in patients with clinical findings of meningitis are as follows:
Medical ManagementManagement of the patient includes:
Pharmacologic ManagementBegin empiric antibiotic coverage according to age and presence of overriding physical conditions.
Nursing ManagementNursing management of the patient with meningitis include the following: Nursing AssessmentAssessment of the patient with bacterial meningitis include.
Nursing DiagnosisBased on the assessment data, major nursing diagnoses include:
Nursing Care Planning & GoalsMain Article: 7 Meningitis Nursing Care Plans Goals for a patient with bacterial meningitis include:
Nursing InterventionsImportant components of nursing care include the following measures:
EvaluationExpected patient outcomes include:
Discharge and Home Care GuidelinesAfter hospitalization, the patient at home should:
Documentation GuidelinesThe focus of documentation in patients with bacterial meningitis are:
Practice Quiz: MeningitisHere’s a 5 item quiz about Meningitis. Please visit our nursing test bank page for more NCLEX practice questions. 1. Tiffany is diagnosed with increased intracranial pressure (ICP); which of the following if stated by her parents would indicate a need for Nurse Charlie to reexplain the purpose for elevating the head of the bed at a 10 to 20-degree angle? A. Help alleviate headache 1. Answer: B. Increase intrathoracic pressure
2. During assessment, the nurse knows that well-recognized signs common to all types of meningitis include: A. Positive Kernig’s sign 2. Answer: D. Negative Kernig’s sign.
3. The most severe form of meningitis is considered to be: A. Bacterial 3. Answer: A. Bacterial.
4. Meningitis alters intracranial physiology, causing: A. Cerebral edema 4. Answer: D. All of the above changes.
5. In diagnosing seizure, which of the following is the most beneficial? A. Skull radiographs 5. Answer: B. EEG
Which is the priority need that must be included in the nursing care for a child with pneumonia?Initial priorities in children with pneumonia include the identification and treatment of respiratory distress, hypoxemia, and hypercarbia. Grunting, flaring, severe tachypnea, and retractions should prompt immediate respiratory support.
Which step would the nurse undertake during the administration of ear drops in children ages 1 to 3 years?Straighten the ear canal as follows: For children younger than 3 years, gently pull the outer ear down and toward the back of the head. For children older than 3 years, gently pull the outer ear up and toward the back of the head.
Which recent illness would the nurse assess for in a preschooler with Reye syndrome?The two key risk factors associated with Reye's syndrome include a recent viral illness, such as influenza, and the use of aspirin.
Which precursor would the nurse recognize as common in children who develop Reye's syndrome?Reye syndrome is preceded by a viral infection, most commonly chickenpox or influenza.
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