Meningitis Patient Assessment Quiz
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Questions and Answers

Which symptom is highly indicative of meningitis based on the subjective data?

  • Restlessness, irritability
  • Nausea and vomiting
  • Excruciating, constant headache (correct)
  • Hyperactive deep tendon reflexes

What is a classic sign observed during the physical assessment for meningitis?

  • Tachycardia
  • Altered level of consciousness
  • Positive Kernig’s sign (correct)
  • Red macular rash

Which of the following findings during a physical examination could indicate meningeal irritation?

  • Fever and chills
  • Seizures
  • Photophobia
  • Nuchal rigidity (correct)

Which combination of physical assessment findings suggests a higher severity of meningitis?

<p>Altered level of consciousness, seizures (B)</p> Signup and view all the answers

Which objective finding is specifically associated with meningococcal meningitis?

<p>Red macular rash (A)</p> Signup and view all the answers

What does a cloudy appearance of cerebrospinal fluid (CSF) indicate?

<p>Bacterial infection (B)</p> Signup and view all the answers

Which test is most definitive for diagnosing meningitis?

<p>CSF analysis (B)</p> Signup and view all the answers

What initial guideline should be followed when meningitis is suspected?

<p>Isolate the client (C)</p> Signup and view all the answers

What is a key result in the CSF analysis for bacterial meningitis?

<p>Cloudy appearance (B), Elevated protein (C)</p> Signup and view all the answers

Which precaution must be maintained until antibiotics have been administered for at least 24 hours?

<p>Droplet precautions (C)</p> Signup and view all the answers

Why is it important to minimize environmental stimuli for a client with meningitis?

<p>To prevent seizures (B)</p> Signup and view all the answers

What should be monitored to assess for septic shock in a client with meningitis?

<p>Vital signs (C)</p> Signup and view all the answers

Which condition may older adult clients with meningitis be at increased risk for?

<p>Secondary pneumonia (D)</p> Signup and view all the answers

What should be avoided when administering analgesics in the context of increased intracranial pressure (ICP)?

<p>Using opioids to relieve pain (D)</p> Signup and view all the answers

What is the recommended positioning to help reduce increased ICP in a client with meningitis?

<p>Elevating the head of the bed to 30° (C)</p> Signup and view all the answers

Which of the following medications is used as prophylaxis for bacterial infections in individuals close to a meningitis patient?

<p>Ciprofloxacin (A)</p> Signup and view all the answers

In monitoring for complications of meningitis, which indication suggests increased ICP?

<p>Seizures and altered consciousness (B)</p> Signup and view all the answers

What intervention can be administered to quickly reduce increased ICP?

<p>Giving mannitol IV (C)</p> Signup and view all the answers

What is a primary manifestation to monitor for in a client with SIADH?

<p>Dilute blood and concentrated urine (B)</p> Signup and view all the answers

Which intervention is appropriate for managing SIADH?

<p>Fluid restriction (C)</p> Signup and view all the answers

Which medication is typically administered to help treat SIADH?

<p>Demeclocycline (B)</p> Signup and view all the answers

What daily assessment is crucial for a client experiencing SIADH?

<p>Daily weight measurement (D)</p> Signup and view all the answers

In SIADH, what physiological alteration occurs in the urine of affected patients?

<p>Concentrated urine despite high fluid intake (D)</p> Signup and view all the answers

What is one potential risk factor for the occurrence of absence seizures in children?

<p>Genetic predisposition (B)</p> Signup and view all the answers

Which of the following conditions can lead to seizures due to increased intracranial pressure?

<p>Cerebral edema (C)</p> Signup and view all the answers

In older adults, which condition is commonly associated with new-onset seizures?

<p>Heart disease (D)</p> Signup and view all the answers

How can abrupt cessation of antiepileptic drugs (AEDs) affect seizure activity?

<p>It can cause rebound seizure activity. (D)</p> Signup and view all the answers

Which of the following is NOT considered a metabolic disorder that can result in seizures?

<p>Alzheimer's disease (B)</p> Signup and view all the answers

Flashcards

Meningitis Symptoms

Symptoms include fever, headache, neck stiffness, sensitivity to light, nausea, vomiting, altered consciousness, and seizures.

Kernig's Sign

Sign of meningitis; resistance and pain when the leg is extended from a flexed position.

Brudzinski's Sign

Sign of meningitis; flexing the knees and hips causing neck flexion.

Meningitis

Inflammation of the membranes surrounding the brain and spinal cord.

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Photophobia

Sensitivity to light; symptom of meningitis.

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CSF Analysis

The most definitive test for diagnosing meningitis, involves obtaining and analyzing cerebrospinal fluid (CSF) through a lumbar puncture.

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Cloudy CSF

Indicates a bacterial infection in the CSF, often accompanied by elevated white blood cell count, protein, and decreased glucose.

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Clear CSF

Suggests a viral infection in the CSF, typically with normal or slightly elevated white blood cell count.

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Elevated WBC in CSF

A key sign of inflammation, often associated with both bacterial and viral meningitis. Higher counts are usually seen with bacteria.

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Elevated Protein in CSF

Indicates leakage of protein from blood vessels into the CSF, signaling inflammation in the brain or spinal cord.

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Decreased Glucose in CSF

Usually specific to bacterial meningitis, as bacteria consume glucose for energy.

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Counterimmunoelectrophoresis (CIE)

A test performed on CSF to determine the infectious agent, especially if antibiotics were given before CSF collection.

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Droplet Precautions

Isolation measures used for meningitis patients, requiring a private room and limiting close contact with others.

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What is the goal of antibiotics in meningitis?

Antibiotics like ceftriaxone or cefotaxime are given to fight bacterial infections, particularly before lab results confirm the specific causative agent.

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Why do we use phenytoin in meningitis?

Phenytoin is an anticonvulsant used to prevent seizures, which can occur due to increased intracranial pressure (ICP) caused by meningitis.

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Why do we avoid opioids for pain in meningitis?

Non-opioid analgesics like acetaminophen and ibuprofen are preferred for pain relief because opioids can mask changes in neurological function, making it harder to monitor for complications.

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What is the purpose of prophylactic antibiotics in meningitis?

Individuals in close contact with a meningitis patient might receive ciprofloxacin, rifampin, or ceftriaxone to prevent infection, as meningitis is highly contagious.

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How do we manage increased ICP in meningitis?

Managing increased ICP includes elevating the head of the bed to 30 degrees, avoiding coughing and straining, and potentially administering mannitol intravenously.

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SIADH

A condition where the body produces too much antidiuretic hormone (ADH), causing the body to retain too much water, leading to diluted blood and concentrated urine.

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SIADH Complications

SIADH can be a complication of meningitis due to abnormal stimulation of the hypothalamus, which controls ADH release.

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SIADH Nursing Action: Monitor

Monitor for signs of SIADH, including dilute blood (low sodium levels) and concentrated urine.

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SIADH Nursing Action: Interventions

Administer medications like demeclocycline to block ADH action and restrict fluids to help manage water retention.

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SIADH Nursing Action: Weight

Monitor the client's weight daily to assess fluid retention and effectiveness of interventions.

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Seizure Triggers

Factors that can increase the risk of seizures, including genetics, infections, head trauma, and metabolic imbalances.

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Genetic Predisposition to Seizures

Individuals with a family history of seizures may be more likely to experience them, suggesting a genetic influence.

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Seizure Triggers in Older Adults

Cerebrovascular diseases are a common cause of seizures in older adults due to changes in blood flow to the brain.

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Hormonal Influence on Seizures

Hormonal fluctuations associated with menstruation and pregnancy can alter brain activity, potentially triggering seizures.

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Seizure Prevention During Pregnancy

Maintaining consistent antiepileptic medication dosages and monitoring for any changes in seizure patterns is crucial during pregnancy.

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Study Notes

Subjective Data

  • Patient reported excruciating, constant headache.
  • Patient experienced nuchal rigidity (stiff neck).
  • Patient exhibited photophobia (sensitivity to light).

Objective Data: Physical Assessment Findings

  • Patient presented with fever and chills.
  • Patient experienced nausea and vomiting.
  • Patient displayed altered level of consciousness (confusion, disorientation, lethargy, difficulty arousing, or coma).
  • Kernig's sign was positive (resistance and pain with leg extension).
  • Brudzinski's sign was positive (knee and hip flexion with neck flexion).
  • Patient had hyperactive deep tendon reflexes.
  • Patient experienced tachycardia.
  • Seizures were observed.
  • A red macular rash was noted (suggesting meningococcal meningitis).
  • Patient showed restlessness and irritability.

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Description

Test your knowledge on the clinical signs and symptoms of meningitis through a detailed patient case study. Analyze both subjective and objective data to identify critical findings that indicate potential meningococcal meningitis. This quiz is essential for healthcare professionals aiming to enhance their assessment skills.

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