Meningitis nursing, medical managements

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Meningitis MEDICAL MANAGEMENT IDEALDiagnostic Evaluation ? Complete blood count (CBC) with differential – detect an elevated leukocyte count in bacterial and viral meningitis, with a greater percentage of polymorphonuclear leukocytes (90%) in bacterial and (less than 50%) in viral meningitis (normal 0% to 15%) ? Blood cultures – indicate the organism ? Lumbar puncture – shows typical cerebrospinal fluid findings associated with meningitis (elevated CSF pressure, cloudy or milky white CSF, high protein level, positive Gram stain and culture that usually identifies the infecting organism unless its a virus, and depressed CSF glucose concentration) ? CSF evaluation for pressure, leukocytes, protein, glucose. Meningitis precautions CSF normally has five or fewer lymphocytes or mononuclear cells/mm3 o In acute bacterial meningitis, the CSF may indicate elevated pressure, elevated leukocytes (several thousand), elevated protein, elevated glucose. How is meningitis spread A culture and smear will identify the organism. Meningitis b vaccine birmingham WBC differential should be done by a stained smear of sediment o In viral encephalitis, the CSF may indicate normal/moderately elevated pressure, few/elevated leukocytes (fewer than 1,000), normal or slightly elevated protein, normal glucose ? MRI/CT scan – with and without contrast rules out cerebral hematoma, hemorrhage, or tumor ? In patients with acquired immunodeficiency syndrome (AIDS), MRI – detect meningeal irritation, evidence of a sinus infection, or brain abscess. Cerebrospinal meningitis ? CT scan with contrast – to detect abscesses. Early symptoms of meningitis ? Low CD4+ counts indicate immunosuppression in HIV-positive patients and other patients with immunosuppressive disorders. Meningitis injection ? Latex agglutination may be positive for antigens in meningitis. Meningococcal rash ? Chest X-rays – may reveal pneumonitis or lung abscess, tubercular lesions, or granulomas secondary to fungal infection. Meningitis airborne Sinus and skull films may help identify the presence of cranial osteomyelitis, paranasal sinusitis, or skull fracture.Treatment ? The assessment and management of meningitis should be approached through a team effort with nursing, infectious diseases specialists, neurology, internal medicine, and otolaryngology specialists, and laboratory and diagnostic staff. Meningite viral cirurgia ? Antibiotic therapy and vigorous supportive care. Can you catch meningitis For viral meningitis, treatment is supportive. Viral meningitis rash ? Usually, I.V. Meningite febbre antibiotics are given for at least 2 weeks, followed by oral antibiotics.

? The antibiotic administered is specific to the type of meningitis; typical agents include ampicillin, cefotaxime, ceftriaxone, and nafcillin.? Dexamethasone (Decadron) – as adjunctive therapy in the treatment of meningitis caused by H. Meningitis vaccine schedule influenzae type B and in pneumococcal meningitis if given before the first dose of antibiotic. Meningitis b vaccine usa It has also been shown to reduce the incidence of deafness, a common complication of meningitis.? Mannitol – to decrease cerebral edema? Anticonvulsant (usually given I.V.) or a sedative – to reduce restlessness? Aspirin or acetaminophen – to relieve headache and fever? Supportive measures consist of bed rest, hypothermia, and fluid therapy to prevent dehydration.? Isolation – if nasal cultures are positive.? Therapy for any coexisting conditions, such as endocarditis or pneumonia.? Temozolomide (Temodar) – a second-generation alkylating agent, effective against many cancers that result in neoplastic meningitis. Meningite encefalite External beam radiation may be used in conjunction with chemotherapy (eg, intrathecal thiotepa or methotrexate).? Cochlear implantation rehabilitation – due to deafness caused by meningitis should be considered.? If meningitis is suspected after neurosurgical procedures, potential I.V. Meningitis spinal line bacteremia, CSF leak, or immunosuppression, therapy is also indicated for S. Meningitis trust aureus and gram-negative bacilli.? Antifungal agents, such as amphotericin B (Fungizone) and the triazoles, fluconazole (Diflucan) and itraconazole (Sporanox), are indicated for cryptococcal meningitis.? Empiric antituberculosis drugs must be initiated if infection by Mycobacterium tuberculosis is suspected.

NURSING MANAGEMENT IDEALNursing Assessment ? Obtain a history of recent infections such as upper respiratory infection, and exposure to causative agents. Is meningitis a live vaccine ? Assess neurologic status and vital signs. Spinal bacterial meningitis ? Evaluate for signs of meningeal irritation. Meningitis vaccine rash ? Assess sensorineural hearing loss (vision and hearing), cranial nerve damage (eg, facial nerve palsy), and diminished cognitive function.Nursing Diagnoses ? Acute pain related to meningeal irritation ? Anxiety ? Hyperthermia related to the infectious process and cerebral edema ? Impaired gas exchange ? Impaired Physical Mobility related to prolonged bed rest ? Ineffective Tissue Perfusion (cerebral) related to infectious process and cerebral edema ? Risk for deficient fluid volume related to fever and decreased intake ? Risk for impaired skin integrityKey outcomes The patient will ? express feelings of comfort and relief of pain ? identify strategies to reduce anxiety ? exhibit temperature within normal range ? maintain adequate ventilation and oxygenation ? maintain fluid volume within normal range ? Have skin integrity remain intactNursing Interventions

Reducing Fever ? Administer antimicrobial agents on time to maintain optimal blood levels. Bacterial and viral meningitis ? Monitor temperature frequently or continuously, and administer antipyretics as ordered. Early signs of meningitis in toddlers ? Institute other cooling measures, such as a hypothermia blanket, as indicated.Maintaining Fluid Balance ? Prevent I.V. Meningitis symptoms adults fluid overload, which may worsen cerebral edema. Meningitis how long ? Monitor intake and output closely. Infant viral meningitis ? Monitor CVP frequently.Enhancing Cerebral Perfusion ? Assess LOC, vital signs, and neurologic parameters frequently. Meningitis b vaccine uk private Observe for signs and symptoms of ICP (eg, decreased LOC, dilated pupils, widening pulse pressure). Adult viral meningitis ? Maintain a quiet, calm environment to prevent agitation, which may cause an increased ICP. Q es meningitis aguda ? Prepare patient for a lumbar puncture for CSF evaluation, and repeat spinal tap, if indicated. Signs of meningitis in babies Lumbar puncture typically precedes neuroimaging ? Notify the health care provider of signs of deterioration: increasing temperature, decreasing LOC, seizure activity, or altered respirations.Reducing Pain ? Administer analgesics as ordered; monitor for response and adverse reactions. Treatment for bacterial meningitis Avoid opioids, which may mask a decreasing LOC. Meningitis w vaccine nhs ? Darken the room if photophobia is present. Vacina meningite 3 meses reacao ? Assist with position of comfort for neck stiffness, and turn patient slowly and carefully with head and neck in alignment. Meningite ? Elevate the head of the bed to decrease ICP and reduce pain.Promoting Return to Optimal Level of Functioning ? Implement rehabilitation interventions after admission (eg, turning, positioning). Neck pain and meningitis ? Progress from passive to active exercises based on the patients neurologic status.Community and Home Care Considerations ? Prevent bacterial meningitis by eliminating colonization and infection with the offending organism. Meningitis nuchal rigidity o Administer vaccines against H. Treatment for spinal meningitis influenzae type B for children; N. What is meningitis encephalitis meningitidis serogroups A, C, Y, and W135 for patients at high risk (especially college students, those without spleens, immunodeficient); and S. What are the signs of meningitis pneumoniae for patients with chronic illnesses and the elderly. Meningite contagiosa o Administer vaccines for travelers to countries with a high incidence of meningococcal disease and household contacts of someone who has had meningitis. Haemophilus meningitis o Chemoprophylaxis for meningococcal disease, most commonly with rifampin, may be necessary for health care workers, household contacts in

the community, day care centers, and other highly susceptible populations. Meningitis que es y sintomas ? If maintenance antifungal prophylaxis is initiated for patients with low CD4+ counts, as seen in some patients with AIDS, the patient must understand the importance of long-term pharmacologic therapy.Patient Education and Health Maintenance ? Advice close contacts of the patient with meningitis that prophylactic treatment may be indicated; they should check with their health care providers or the local public health department. What is meningitis symptoms ? To help prevent the development of meningitis, teach patients with chronic sinusitis or other chronic infections the importance of proper medical treatment. Canine meningitis ? Encourage the patient to follow medication regimen as directed to fully eradicate the infectious agent. Meningitis long term effects ? Encourage follow-up and prompt attention to infections in future. What is pyogenic meningitis ? Inform patients who have children about the importance of vaccination with measles, mumps, rubella vaccine, H. Meningitis vaccine dangers influenzae type B vaccine, and pneumococcal vaccine as a preventive measure. Meningitis effects Vaccination is recommended for children younger than school age.Evaluation: Expected Outcomes ? Afebrile ? Adequate urine output; CVP in normal range ? Alert LOC; normal vital signs ? Pain controlled ? Optimal level of functioning after resolution

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