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