Nursing 213

N213: Health Differences Across the Lifespan 3 Study Guide care. Bacterial meningitis is more serious and requires prompt treatment with antibiotics. The causative organisms of bacterial meningitis are haemophilus influenza, streptococcus pneumoniae, and Neisseria meningitides. Without treatment, people that are very young, elderly, or immunocompromised are at high risk of complications and/or death from meningitis. Complications include increased intracranial pressure, seizures, and central nervous system dysfunction. Signs and symptoms of meningitis: • Headache • Neck pain • Neck stiffness (nuchal rigidity) • Fever • Fatigue • Photophobia • Seizures • Chills • Brudzinski’s sign (hip flexion) • Kernig’s sign (pain with knee flexion) • Increased deep tendon reflexes • Waterhouse-Friderichsen Syndrome (DIC-petechiae) • Sensory loss • Twitching • Vomiting Nursing assessment for meningitis: • Head to toe general assessment o Neurological status: level of consciousness, seizure activity, Brudzinski’s sign, Kernig’s sign, reflexes, sensory, and photophobia o Check vital signs: TPR and blood pressure • Review laboratory reports o Lumbar puncture: checks for infection, causative organism, and clarity/blood in fluid; most common causative organism is Nesseria meningitides; prepare patient for LP, place in side-lying position with head tochest o CBC with differential: check for increased white blood cells and shift in differential, which may indicate possible viral pathology o Blood cultures: assists with finding organism and sensitivity toantibiotics o CT scan: checks for cerebral edema o Chest x-ray: checks for complications and other causes Nursing diagnosis for meningitis: • Risk for altered body temperature due to infectious process, secondary to meningitis • Risk for altered thought processes related to decreased level of consciousness • Risk for injury related to changes in mental status, secondary to meningeal inflammation

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