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.
22 Jan – 28 Feb
Concepts Covered:
- Cardiovascular
- Circulatory System
- Nervous System
- Skeletal System
- Emergency Care of the Cardiac Patient
- Neurological
- Respiratory
- Urinary System
- Respiratory System
- Endocrine System
- Studying
- Tissues and Glands
- Medication Administration
- Hematologic System
- Digestive System
- Reproductive System
- Endocrine and Metabolic Disorders
- Muscular System
- Sensory System
- Basics of Human Biology
- Prefixes
- Suffixes
- Fetal Development
- Terminology
- Proteins
- Statistics
- Med Term Basic
- Med Term Whole
- Preoperative Nursing
- Integumentary Disorders
- Urinary Disorders
- Noninfectious Respiratory Disorder
- Cardiac Disorders
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Central Nervous System Disorders – Brain
- Hematologic Disorders
- Delegation
- Perioperative Nursing Roles
- Acute & Chronic Renal Disorders
- Respiratory Emergencies
- Disorders of the Adrenal Gland
- Documentation and Communication
- Legal and Ethical Issues
- Factors Influencing Community Health
- Immunological Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Vascular Disorders
- Renal Disorders
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Gastrointestinal Disorders
- Newborn Complications
- Peripheral Nervous System Disorders
- Communication
- Microbiology
- Emergency Care of the Trauma Patient
- Integumentary Disorders
- Musculoskeletal Disorders
- EENT Disorders
- Postoperative Nursing
- Neurological Emergencies
- Disorders of Thermoregulation
- Neurological Trauma
- Basics of NCLEX
- Fundamentals of Emergency Nursing
- Integumentary Important Points
- Multisystem
- Test Taking Strategies
- Emergency Care of the Neurological Patient
- Neurologic and Cognitive Disorders
- Central Nervous System Disorders – Spinal Cord
- Renal and Urinary Disorders
- Respiratory Disorders
- Infectious Disease Disorders
- EENT Disorders
- Emergency Care of the Respiratory Patient
- Adult
- Anxiety Disorders
- Depressive Disorders
- Dosage Calculations
- Understanding Society
- Concepts of Pharmacology
- Newborn Care
- Adulthood Growth and Development
- Pregnancy Risks
- Postpartum Complications
- Substance Abuse Disorders
- Bipolar Disorders
- Learning Pharmacology
- Psychotic Disorders
- Prenatal Concepts