Neuro
Meningitis
Pathophysiology
Causes
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Meningitis is the inflammation of the Meninges
(the inner lining of the brain & spinal cord)
Inflammation → massive brain swelling → deadly
↑ ICP → leading to death
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- Infection, head trauma, & auto-immune diseases (Lupus)
Memory Trick
• Bacterial = Bad news MOST contagious
• Viral = Very common - MOST tested
Signs & Symptoms
Diagnostics
H - Headache & Photophobia
H - Hard stiff neck “Nuchal rigidity”
H - High Temp. “Fever”
• Pediatrics
• High-pitched cry
• Bulging fontanelle
• Adults
• Agitation & altered LOC (1st sign)
• Leads to seizures, coma, & DEATH!
• + Kernig Sign: Laying on the back & straightening
the leg = very painful.
• + Brudzinski Sign: when neck flexes, hip & knees also
flex.
Memory Trick:
- Kernig “Krinkle”
- Brudzinski “Beach Chair”
Tests:
• CT scan (done first)
• LP (Lumbar Puncture “spinal tap”)
- Viral - Very clear
- Bacterial - Bad cloudy
- Both types will have elevated WBCs
- AFTER LP: Monitor insertion site dressing
for clear fluid
Droplet
P - Pertussis
I - Influenza
M - Meningitis
P - Pneumonia
1. Surgical Mask & Goggles
2. Single room
ATI
Teach unlicensed personnel
to wear a mask
Put ON “DON”
GMGG
Interventions
• First action
- Place client on droplet precautions - PPE 1st!
Airborne
KAPLAN Scenario
M - Measles
T - TB (Tuberculosis)
V - Varicella (shingles/chicken pox)
ON AIR
1. N95 mask - Staff
2. Neg. Pressure Room
3. Door closed
4. Transport - Patient wears
surgical mask
Take OFF “DOFF”
GGGM
1. Gown
1. Gloves
2. Mask
2. Goggles
3. Goggles
3. Gown
4. Gloves
4. Mask
N95
Question: Client with
suspected meningitis…
when neck flexes, the
hip and knee also flex.
Priority action?
Answer: Immediately
report this finding to
the HCP!!!
NCLEX question
Client admitted for bacterial
meningitis with a BP of
78/56… priority action?
Admin. bolus of IV
normal saline
Interventions
• LOW BP will kill!
• Low noise - quiet room
• Low light - photophobia
• Low pressure all over:
• NO coughing
• NO sneezing
• NO bending extremities
• RAISE HOB at least 30 degrees
Early Sign of ↑ ICP: NCLEX TIP
• Altered LOC: Restlessness, Irritability, Agitation
• Decreased Mental Status