Meningitis for Certified Emergency Nursing (CEN)
Included In This Lesson
Study Tools For Meningitis for Certified Emergency Nursing (CEN)
Outline
Meningitis
Definition/Etiology:
The meninges is the lining of the brain and spinal cord. When that gets infected, either by a virus or a bacteria, it’s not good. Now viral meningitis isn’t that bad. The symptoms are usually mild and it resolves with supportive care.
Now bacterial on the other hand is the one we all freak out about! This is the one that kills people if not treated.
Pathophysiology:
The patho behind meningitis is fairly simple. Basically, a virus or bacteria enters the CSF and growth of that organism leads to inflammation within the CSF. Some of the common bugs that cause bacterial meningitis are Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis and meningococcal (which is most common in young adults). It would be a good practice to get vaccine history, like the meningitis vax. While viral meningitis is usually not contagious, bacterial is by droplets and secretions.
Clinical Presentation:
- Headache, fever, malaise
- Irritability, restlessness, altered LOC in severe cases
- Nausea and vomiting
- Petechial rash (usually a sign of meningococcal meningitis)
- Stiff neck, PHOTOPHOBIA!
2 textbook signs you need to know!
- Kernig’s sign: Position the patients supine with their hips flexed to 90°. This test is positive if there is pain on passive extension of the knee.
- Brudzinski’s sign: Position the patients supine and passively flex their neck. This test is positive if this maneuver causes reflex flexion of the hip and knee.
Collaborative Management:
Basic lab work, CBC, CMP, but the one that is most diagnostic is the lumbar puncture. The results will tell us if it’s viral or bacterial. If it’s viral, the glucose will be normal, protein slightly increased and a negative gram stain. With bacterial, the glucose is decreased, the protein is elevated, and the gram stain is positive. For our part, while we don’t do the actual tap, we assist the doc here. Set up the area, prep the patient, and take the samples to the lab. Most facilities want these hand delivered.
With the alteration in LOC, a CT head may be indicated.
Treatment for viral, like we said, is supportive care. Treatment for bacterial is urgent antibiotic therapy (probably rocephin), anti-epileptics and antiemetics if necessary and of course Tylenol to bring that fever down.
Evaluation | Patient Monitoring | Education:
- Hemodynamic monitoring as usual
- Serial neuro checks
- Monitor for seizures
- Isolation (bacterial, not viral…. Iso until not iso)
Linchpins: (Key Points)
- Textbook signs: Kernig’s and Brudzinski
- Iso until not iso
- Bacterial vs viral
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/
References:
- Emergency Nurses Association. (2022). Emergency Nursing Orientation 3.0. Cambridge, MA: Elsevier, Inc.
- Sheehy, S. B., Hammond, B. B., & Zimmerman, P. G. (2013). Sheehy’s manual of emergency care (Vol. 7th Edition). St. Louis, MO: Elsevier/Mosby.
Yaaaaaah Med Surg
Concepts Covered:
- Musculoskeletal Trauma
- Musculoskeletal Disorders
- Emergency Care of the Trauma Patient
- Shock
- Acute & Chronic Renal Disorders
- Vascular Disorders
- Disorders of the Thyroid & Parathyroid Glands
- Cardiac Disorders
- Emergency Care of the Cardiac Patient
- Disorders of the Posterior Pituitary Gland
- Infectious Disease Disorders
- Infectious Respiratory Disorder
- Intraoperative Nursing
- Medication Administration
- Urinary Disorders
- Upper GI Disorders
- Lower GI Disorders
- Hematologic Disorders
- Male Reproductive Disorders
- Neurological Trauma
- Neurological Emergencies
- Noninfectious Respiratory Disorder
- Respiratory System
- Respiratory Emergencies
- Immunological Disorders
- Central Nervous System Disorders – Brain
- Renal Disorders
- Emergency Care of the Neurological Patient
- EENT Disorders
- EENT Disorders
- Liver & Gallbladder Disorders
- Shock
- Studying
- Disorders of Pancreas
- Respiratory
- Emergency Care of the Respiratory Patient
- Perioperative Nursing Roles
- Oncology Disorders
- Integumentary Disorders
- Postoperative Nursing
- Communication
- Legal and Ethical Issues
- Preoperative Nursing
- Documentation and Communication
- Fundamentals of Emergency Nursing
- Sexually Transmitted Infections
- Female Reproductive Disorders
- Peripheral Nervous System Disorders
- Central Nervous System Disorders – Spinal Cord
- Integumentary Disorders
- Disorders of Thermoregulation
- Neurologic and Cognitive Disorders
- Renal and Urinary Disorders
- Disorders of the Adrenal Gland
- Respiratory Disorders
- Integumentary Important Points
- Urinary System
- Tissues and Glands
- Microbiology
- Factors Influencing Community Health
- Multisystem
- Delegation
- Basics of NCLEX
- Circulatory System
- Cognitive Disorders
- Neurological
- Gastrointestinal
- Endocrine
- Cardiovascular