RN ADULT MEDICAL SURGICAL NURSING CHAPTER 5 Meningitis 31
UNIT 2 NURSING CA RE OF CLIENTS W HO HAVE
NEUROSENSORY DISORDERS
SECTION: CENTRAL NER VOUS SYSTEM DISORDERS
CHAPTER 5 Meningitis
Meningitis is an inflammation of the meninges,
which are the membranes that protect the brain
and spinal cord.
Viral, or aseptic, meningitis is the most common
form of meningitis and commonly resolves
without treatment. Fungal meningitis is common
in clients who have AiDs. Bacterial (or septic)
meningitis is a contagious infection with a high
mortality rate. the prognosis depends on how
quickly care is initiated.
there are three vaccines for different pathogens
that cause bacterial meningitis. One is available
for high-risk populations, such as residential
college students.
HEALTH PROMOTION AND
DISEASE PREVENTION
Haemophilus influenzae t ype b (Hib) vaccine
Ensure infants receive vaccine for bacterial meningit is
on schedule. A series of four doses is recommended
beginning at 2 months of age, with the final dose at 12 to
15 months.
Pneumococcal polysaccharide vaccine (PPSV)
Though primar ily intended to prevent respiratory
infection, t his immuni zation also decreases the
risk for CNS infections. Vaccinate adults who are
immunocompromised, have a chronic di sease, smoke
cigarettes, or live in a long-term care facility. Follow CDC
guidelines for reimmunization. Give one dose to adults
older than 65 who have not prev iously been immunized
nor have history of disease.
Meningococcal vaccine (MCV4) (Neisseria meni ngitidi s)
Ensure that adolescents receive the v accine on sche dule
and prior to livi ng in a residential setting in college.
Individuals i n other communa l living cond itions (e.g.,
military) also should be immunized. An initial dose is
recommended for healt hy children between the ages of 11
to 12, with a booster administered at age 16.
ASSESSMEN T
RisK FACtORs
Viral meningit is
●Viral il lnesses such as the mumps, measles, herpes, and
arboviruses (West Nile).
●There is no vaccine against v iral meningitis.
Fungal meningitis: Fulmina nt fungal-based infection of
the sinuses are f rom the organi sm Cryptococcu s neoformans.
Bacterial meningitis: Bacterial-based infect ions, such
as otitis med ia, pneumonia, or sinusitis, in which the
infectious micro-organism is Neisseria meningitidis,
Streptococcus pneumoniae, or Haemophilus influenzae
Immunosuppression
Direct contamination of spinal fluid
Invasive procedures, skull fracture, or
penetrating wound.
Environment: Overcrowded living conditions.
eXPeCteD FinDings
SUBJECTIVE DATA
●Excruciating, constant headache
●Nuchal rigid ity (stiff neck)
●Photophobia (sensit ivity to light)
OBJECTIVE DATA: Physical Assessment Findings
●Fever and chil ls
●Nausea and vomiting
●Altered level of con sciousness (confusion, disorientation,
letharg y, difficulty arousing, coma)
●Positive Kernig’s sign (resista nce and pain with
extension of t he client’s leg from a flexed position)
●Positive Brudzi nski’s sign (flexion of the knees and hips
occurring with deliberate flexion of t he client’s neck)
●Hyperactive deep tendon reflexes
●Tachycardia
●Seizures
●Red macular r ash (meningococcal meningit is)
●Restlessness, irrit abilit y
LABORAtORY tests
●Urine, throat, nose, and blood culture and sensitiv ity:
Perform cult ure and sensitiv ity of var ious body fluids to
identify possible infectious bacteria and an appropriate
broad-spectrum a ntibiotic. Not definitive for meningitis
but can guide in itial selec tion of antim icrobial.
●CBC: Elevated WBC count
CHAPTER 5 Online Videos: Positive Kernig’s Sign
Positive Brudzinski’s Sign
