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Chapter 5
Unit 2: Nursing care of clients with neurosensory disorders
| Question | Answer |
|---|---|
| Meningitis (Pg. 53) | Inflammation of the meninges (membranes that protect the brain and spinal cord) |
| What is the most common type of meningitis? | Viral (aseptic); resolves w/o tx |
| Which type of meningitis has a high mortality rate? | Bacterial (septic), it's contagious |
| Are there meningitis vaccines? (Pg. 53) | Yes 3; one is available for high-risk populations; college students |
| Is there a vaccine against viral meningitis? & risks | No. Risks to getting; mumps, measles, herpes, west nile |
| Bacterial meningitis risks | Immunosuppression, invasive procedures, skull fractures, penetrating head wound, overcrowding living |
| Patient complaints: | Excruciating, constant headache Nuchal rigidity (stiff neck) Photophobia (sensitivity to light) |
| Signs/symptoms: | Fever/chills, nausea/vomiting, altered LOC, positive kernig's sign, positive brudzinski's sign, hyperactive DTR's, tachycardia, seizures, red macular rash, restless, irritable |
| Positive kerning's sign: | Resistance & pain w extension of the client's leg from flexed position |
| Positive brudzinski;s sign | Flexion of extremities occurring w deliberate flexion of the client's neck |
| LABS | Urine, throat, nose & blood C&S -not definitive for meningitis but can guide initial antimicrobial (broad) tx CBC- elevated WBC's |
| Dx meningitis: (pg. 55) | CSF analysis: by lumbar puncture, most definitive -cloudy CSF (bacterial), clear (viral) -^ WBC, protein & CSF pressure, and low glucose, |
| Nursing: precautions | Isolate as soon as suspected -Droplet precautions; private room, con't until abx con't for 24hrs & when oral.nasal secretions no longer infectious |
| Nursing: Fever, stimuli, bed rest, ICP | Fever reducing; cool blanket Low stimuli; low lights, quiet Bed rest head ^ 30 degrees If ^ ICP; avoid cough/sneeze |
| Nursing: Seizures, fluids, | Replace as indicated by labs, seizure precautions |
| Medications to treat Meningitis | Ceftriaxone (Rocephin) or Cefotaxime (Claforan) in combination w/ Vancomyin -Give until C&S available |
| Med if seizures or ^ ICP | Anticonvulsants; Phenytoin (Dilantin) |
| Analgesics for headaches and/or fever | Acetaminophen (tylenol) or Ibuprofen (Motrin) -Nonopioids to avoid changing LOC |
| S/S of ^ ICP (complication of meningitis) | Decreased LOC, pupillary changes, impaired extraocular movements |
| Interventions to reduce ICP | Positioning & avoiding coughing/sneezing/straining |
| Complication of Meningitis: | SIADH: syndrome of inappropriate ADH -d/t abnormal stimulation of the hypothalamic area (excess secretion of ADH) |
| S/S SIADH & tx | -Dilute blood, concentrated urine -Restrict fluids and administer Demeclocycline (Declomycin) |
| Septic emboli (another complication) | Can lead to DIC -Mostly travel to hands & feet.. could develop into gangrene |
Created by:
mary.scott260!
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