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.
review all the things
Concepts Covered:
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Newborn Complications
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Multisystem
- Neurological
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Medication Administration
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Documentation and Communication
- Preoperative Nursing
- Endocrine System
- Legal and Ethical Issues
- Basics of NCLEX
- Communication
- Understanding Society
- Immunological Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Eating Disorders
- Prenatal Concepts
- Anxiety Disorders
- Depressive Disorders
- Oncology Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Gastrointestinal Disorders
- Circulatory System
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Nervous System
- Microbiology
- Hematologic Disorders
- Emergency Care of the Trauma Patient
- Newborn Care
- Digestive System
- Urinary Disorders
- Postpartum Care
- Infectious Respiratory Disorder
- Integumentary Disorders
- Terminology
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Postpartum Complications
- Postoperative Nursing
- Neurological Emergencies
- Vascular Disorders
- Disorders of Thermoregulation
- Statistics
- Neurological Trauma
- Cardiovascular Disorders
- Basic
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Delegation
- Perioperative Nursing Roles
- Developmental Considerations
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Renal Disorders
- Concepts of Pharmacology
- Integumentary Important Points
- Fetal Development
- Renal and Urinary Disorders
- Community Health Overview
- Developmental Theories
- Labor and Delivery
- Infectious Disease Disorders
- Musculoskeletal Disorders
- Basics of Human Biology
- Psychological Emergencies
- Adulthood Growth and Development
- Growth & Development
- Female Reproductive Disorders
- Sexually Transmitted Infections
- Proteins
- Hematologic Disorders
- Tissues and Glands
- Somatoform Disorders
- Oncologic Disorders
- Skeletal System
- Basics of Sociology
- Bipolar Disorders
- Emotions and Motivation
- Peripheral Nervous System Disorders
- Central Nervous System Disorders – Spinal Cord
- Neonatal
- Male Reproductive Disorders
- Prioritization
- Pediatric
- Psychological Disorders
- State of Consciousness
- Sensory System