NUR 265 EXAM 3 REVIEW
MENINGITIS
Patho: Inflammation of the inner meninges Usually caused by:
1. Autoimmune reaction
2. Adverse reaction to medication or procedure (Spinal or Brain) direct route of entry
3. Infection:
a. Bacterial: Most common Strep. Pneumoniae and Neisseria Meningitids...
nur 265 exam 3 review meningitis patho inflammation of the inner meninges usually caused by 1 autoimmune reaction 2 adverse reaction to medication or procedure spinal or br
Written for
NUR 265
All documents for this subject (677)
Seller
Follow
NURSEREP
Reviews received
Content preview
NUR 265 EXAM 3 REVIEW
MENINGITIS
Patho: Inflammation of the inner meninges Usually caused by:
1. Autoimmune reaction
2. Adverse reaction to medication or procedure (Spinal or Brain) direct route of entry
3. Infection:
a. Bacterial: Most common Strep. Pneumoniae and Neisseria Meningitids Highly contagious (see risks)
b. Viral: Most common herpes, Varicella (chicken pox/shingles)
c. Fungal: Usually seen in pts w/ AIDs
Risks:
- Infections of eye, ear, mouth (like a tooth abscess) and neck are at increased risk a/r close anatomic proximity
- Pts ages 16-21 at highest risk for bacterial meningitis. Vaccinate @11-12 y/o then booster @16.
- Pts living in high density populations (dorms, barracks, crowded living areas) have increased risk for
bacterial meningitis as well. Initial or booster vaccination is advised for these adults.
- Pts who are immunocompromised AIDs, Cancer Rx tx, or pts receiving immunosuppressant tx for organ transplant or
autoimmune disease.
S/S:
- Classical Triad: Headache, Fever, Neck pain (nuchal rigidity)
- Kerning’s sign (may or may not be present) back pain when flexing knee beyond 90 degrees w/ pt in supine position
- Brudzinski’s sign (may or may not be present) flexing the head when pt is in supine position results in automatic
flexion of legs and/or hips
- Photo and Phonophobia
- Rhinorrhea (nasal discharge of CSF basal skull fracture) or Otorrhea (ear discharge same as rhinorrhea)
- ICP changes in mental status/LOC and/or orientation can progress to seizures
- Systemic Inflammatory response Coagulopathy changes in vascular status if thrombi forms DIC, gangrene
- Other usual s/s of infection may or may not be present (like tachycardia, fever, chills etc.)
Dx:
CT – if pt is >60, immunocompromised, or have s/s of ICP then CT first all other LP.
LP – If viral CSF is usually clear and if bacterial usually cloudy. All other findings such as glucose, WBC and protein are
usually the same.
Management:
- Priority = Airway Breathing and Circulation + Monitoring + documenting neuro status (q2-4h)
- Seizure precautions
- BS AB tx until LP results then specific Rx tx.
- Managing ICP Mannitol and Antiepilectic rx
- If bacterial meningitis DROPLET + STANDARD
- prophylaxis tx for close contact
- Decrease stimuli + keep HOB elevated at 30 degrees.
ENCHEPALITIS
Patho: Inflammation of the brain and surrounding meninges. Most commonly caused by viral infections such as Herpes
(HSV1) and Varicella
S/S:
-Changes in mental status such as agitation, acute confusion, irritability or personality/behavioral changes
-ICP
-Neurological deficits vision loss, seizures, muscle weakness, and paralysis. **these changes may last for weeks and may
be permanent.
- photo and phonophobia
Management:
-Priority = Airway. Turn cough and deep breathe q2h UNLESS ICP present. If on vent and s/s of ICP suction
-Monitor Neuro Status:
-Glasgow Coma Scale max score of 15, min of 3 (totally dependent) Any change >2 notify MD
-Any change in neuro status such as increasingly dilated pupils or decreased responsiveness to light, new onset of
bradycardia, widening pulse pressure (basically s/s of increasing ICP) or irregular resp effort notify MD
, -Medication viral = acyclovir
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller NURSEREP. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.49. You're not tied to anything after your purchase.
