Coli Meningitis Overview

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Questions and Answers

What is the priority protocol for a nurse assigned to a client newly diagnosed with active tuberculosis?

Reinforce for all to wash their hands before and after entering the room

Have the client cough into a tissue and dispose in a separate bag

Instruct the client to cover the mouth with a tissue when coughing

Place client in a negative pressure private room and have all who enter the room use masks with shields (correct)

Which test is considered the primary diagnostic test for tuberculosis in the Philippines?

Bronchoscopy

Chest x-ray

Direct sputum smear microscopy (correct)

Tuberculin test

What is the recommended procedure before obtaining a sputum specimen for tuberculosis diagnosis?

Gargle with water only (correct)

Have the client refrain from eating before the specimen collection

Brush teeth and use mouthwash

Drink water 30 minutes before collection

Which interpretation indicates a positive result for multidrug-resistant tuberculosis in the Xpert MTB test?

RR for Rifampicin Resistance Signup and view all the answers

In managing a case of tuberculosis, what follows after case finding for its control to be effective?

Home visits Signup and view all the answers

What should be avoided prior to collecting a sputum sample in the morning for tuberculosis testing?

Tooth brushing Signup and view all the answers

What indication does the Mantoux test provide regarding tuberculosis?

Indicates exposure to tuberculosis Signup and view all the answers

What is necessary for a sputum specimen collection to be optimal?

Collecting it in the early morning and ensuring proper technique Signup and view all the answers

Which sign indicates meningeal irritation when the child's neck is flexed?

Brudzinski Sign Signup and view all the answers

What color of cerebrospinal fluid (CSF) is typically associated with viral meningitis?

Clear Signup and view all the answers

Which laboratory finding is indicative of bacterial meningitis?

Increased white blood cell count and decreased glucose Signup and view all the answers

What is the primary mode of transmission for paramyxovirus infections?

Droplet transmission Signup and view all the answers

Which option describes a positive Kernig's sign?

Pain when extending the knee Signup and view all the answers

Which symptom is NOT characteristic of increased intracranial pressure (ICP) in adults?

High-pitched cry Signup and view all the answers

Which method is least likely to be responsible for infection transmission in this context?

Contaminated drinking water Signup and view all the answers

In the nursing care plan, which action should the nurse avoid to minimize pain during positioning?

Extending the leg Signup and view all the answers

Which type of leukocyte is primarily involved in initiating the inflammatory response and arriving first at an injury site?

Neutrophils Signup and view all the answers

What is the appropriate nursing action for discarding used needles and syringes after an injection?

Discard the uncapped needle and syringe into a puncture-resistant container. Signup and view all the answers

For an immunosuppressed patient, which item should be prohibited from visitors?

Fresh potted plants. Signup and view all the answers

Which of the following waste types is indicated by the yellow color coding for disposal?

Infectious waste Signup and view all the answers

Which factor is NOT directly associated with the development of Clostridium difficile infection?

Contaminated food and water Signup and view all the answers

During phagocytosis, which cells are primarily responsible for this process in the immune response?

Neutrophils Signup and view all the answers

What is one of the main roles of basophils in the immune response?

Release histamine during allergic reactions. Signup and view all the answers

Which of these nursing actions would be considered inappropriate when handling sharps?

Recapping the needle before disposal. Signup and view all the answers

What is the primary reason for using multi-drug therapy in treating tuberculosis?

It reduces the development of resistant strains of bacteria. Signup and view all the answers

What is the initial screening test used for detecting HIV in a patient?

ELISA/EIA test Signup and view all the answers

During the window period for HIV testing, what can be expected regarding the presence of antibodies?

No antibodies will be detected until approximately 2 weeks to 6 months. Signup and view all the answers

What is a significant complication associated with untreated gonorrhea in women?

It may lead to serious reproductive health issues. Signup and view all the answers

Which of the following tests is confirmatory for HIV after a positive screening?

Western blot test Signup and view all the answers

Why might a patient with HIV not immediately test positive using an antibody test?

The patient has not been infected long enough to produce antibodies. Signup and view all the answers

Which approach is often recommended for the treatment of gonorrhea in women?

Antibiotics are effective and usually provided. Signup and view all the answers

What viral component is checked in a virological test for HIV?

Amount of viral load Signup and view all the answers

What type of fever pattern is most consistent with a diagnosis of dengue fever?

Saddleback or biphasic fever pattern Signup and view all the answers

Which combination of warning signs is crucial to monitor for severe dengue?

Abdominal pain, vomiting blood, and rapid breathing Signup and view all the answers

During which stage of the dengue virus transmission cycle does infection initially occur?

When an infected mosquito bites an uninfected human Signup and view all the answers

What isolation measure is most appropriate for preventing dengue virus transmission to others?

Screen the environment to avoid attracting mosquitoes Signup and view all the answers

What is the primary concern regarding immunity after a dengue fever infection?

Immunity pertains only to the infected serotype Signup and view all the answers

What is the case fatality rate for severe dengue as opposed to dengue fever?

Severe dengue has a case fatality rate of 44% Signup and view all the answers

What is a common misconception about the symptoms of dengue that should be corrected?

Headache is not a critical warning sign of severe dengue Signup and view all the answers

When can a child with active chickenpox safely return to school?

Once all lesions have fully healed Signup and view all the answers

Study Notes

Coli Meningitis

Caused by a paramyxovirus
Transmitted through droplets
Symptoms include increased intracranial pressure (ICP):
- Infants: high-pitched cry
- Adults: Cushing's Triad
Symptoms also include meningeal irritation
- Brudzinski Sign: flexion of head results in flexion of hips and knees
- Kernig Sign: pain in the hamstring muscle when knee is extended
Diagnosis confirmed through lumbar puncture
- Cloudy cerebrospinal fluid (CSF)
- Increased white blood cell count
- Increased protein
- Decreased glucose

Bacterial vs Viral Meningitis

Bacterial Meningitis
- Cloudy CSF
- Increased WBC
- Increased protein
- Decreased glucose
Viral Meningitis
- Clear CSF
- Slightly increased WBC
- Increased protein
- Normal glucose

Transmission

Possible methods of transmission:
- Contact with respiratory secretions from an infected person
- Hands of caregiver contaminated with local discharges

Nursing considerations for Meningitis

Pain: Nursing diagnosis of pain related to meningeal irritation.
Avoid positioning that can worsen pain, such as: - Extended leg: Kernig's Sign - Neck flexion: Brudzinski Sign - Neck hyperextension
Positioning:
- Consider patient comfort, minimizing movement can reduce pain
Hygiene and Waste:
- Discard used needles and syringes into designated sharps containers. Do not recap needles.
- Maintain separate sharps containers for each patient and in the nurse's station.

Immunosuppression

Avoid fresh plants in patient areas for immunosuppressed patients.

Clostridium Difficile

Clostridium difficile diarrhea is caused by long-term antibiotic therapy.

Tuberculosis

Tuberculosis (TB) is a bacterial infection that primarily affects the lungs
- Symptoms: productive brown sputum
TB is transmitted:
- Air droplets (coughing, sneezing)
TB infected patients should
- Cough in a tissue and properly dispose of the tissue
- Cover their mouth when coughing
- Wear masks when interacting with others
- Protect the greatest number of people
Patient management
- Patient should be isolated in a negative pressure private room
- All healthcare workers entering the room must wear masks with shields
Diagnostic Tests
- Sputum smear microscopy
  - Best time: Early morning
  - No to toothbrush and mouthwash
  - Gargle with water only
  - Inhale, exhale, then cough up phlegm
- Mantoux test (Purified Protein Derivative)
  - Skin test → ID
  - Site: inner surface of the forearm
  - 0.1 ml / 5 unit purified protein ang iinject
  - Interpretation after 48 - 72 hours
- Chest X-ray
- Xpert MTB (can also detect rifampicin resistance) - Results Interpretation - T (+) for MTB - RR (+), Rifampicin Resistance - TI (+) MTB, RR (indeterminate → not sure) - N (-) MTB
The rationale for multi-drug treatment for TB is to reduce the development of resistant strains of bacteria
Case finding is essential for the control of TB
TB case finding should be followed up with regular check-ups.

HIV / AIDS

Causative agent: Retrovirus
- Most common: HIV-1
- African American: HIV-2
Diagnostic Tests:
- Serological Tests
  - EIA / ELISA (check for antibodies)
    - If positive on ELISA, it is only presumptive, as other illnesses can cause a positive result.
  - Western Blot (confirmatory test for HIV-specific antibodies)
- Virological Tests
  - RT PCR (confirmatory)
  - P24 Antigen (part of the virus)
  - Viral load (amount of virus in the blood)
Window period:
- Time after infection but before antibodies are detectable
- Usually 2 weeks to 3 months but can be up to 6 months.

Gonorrhea

In women, gonorrhea can cause:
- Dysuria (painful urination)
- Vaginal bleeding
It can be treated but can lead to serious complications if left untreated.

Dengue Fever

Dengue is a mosquito-borne viral illness
Symptoms:
- Biphasic / Saddleback pattern fever
- Warning Signs:
  - Severe abdominal pain
  - Persistent vomiting
  - Bleeding gums
  - Vomiting blood
  - Rapid breathing
  - Fatigue / restlessness
Dengue fever has a low case fatality rate (less than 1%)
- Severe dengue has a higher case fatality rate (44%)
Dengue transmission cycle:
- Infected mosquitos bite an uninfected human (source of virus)
- Virus multiplies inside the mosquito
- Mosquito bites another human and transmits the virus
Isolation measures for Dengue fever
- Mosquito control: Screen the environment
Immunity:
- Immunity to one dengue serotype does not provide immunity to other serotypes.

Chickenpox

Contagious period:
- Starts 1 to 2 days before the rash appears
- Ends when all the blisters have crusted over
- 8 days after the rash appears = no longer contagious.

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Description

This quiz covers essential information about Coli Meningitis, including its causes, symptoms, and diagnosis. It distinguishes between bacterial and viral meningitis, focusing on the clinical features and laboratory findings that aid in diagnosis.