ATI: RN Nursing care of Children
Questions and Answers
Meningitis
✓ ~~~ an inflammation of the CSF and meninges (which are connective tissues that cover
brain and spinal cord).
Reye Syndrome
✓ ~~~ life-threatening disorder that involved acute encephalopathy and fatty changes of the
liver.
Viral (aseptic) meningitis
✓ ~~~ usually requires only supportive care for recovery
Bacterial (septic) meningitis
✓ ~~~ contagious infection; prognosis depends on how quickly care is initiated.
bacterial meningitis risk factors
✓ ~~~ -infections caused by bacterial agents (meningococcoal), streptococcus
pneumoniae, Hib B, e.coli.
-injuries that provide direct access to CSF
-crowded living conditions
viral meningitis risk factors
✓ ~~~ viral illnesses such as:
- mumps
,-herpes simplex virus
-arbovirus
-adenovirus
-cytomegalovirus
Expected findings of meningitis
✓ ~~~ Photophobia
Nausea
Irritability
Headache
newborn findings of meningitis
✓ ~~~ -no illness present at birth
-poor muscle tone,weak cry, poor suck, refuses feeding, and V/D.
-bulging fontanels are late sign.
3 mth to 2 years findings of meningitis
✓ ~~~ seizures with high-pitched cry
fever and irritability
bulging fontanels
possible nuchal rigidity
poor feeding
,2 years through adolescence physical assessment of meningitis
✓ ~~~ seizures (initial sign)
Positive Brudzinski's sign
Positive Kernig's sign
Nuchal rigidity
fever/chills
headache
vomiting
chronic draining ear (with pneumococcal infection)
Petechiae or purpuric-type rash (with meningococcal infection)
Brudzinski's sign
✓ ~~~ pain with resistance and involuntary flex of hip/knee when neck is flexed to chest
when lying supine
Kernig's sign
✓ ~~~ a diagnostic sign for meningitis marked by the person's inability to extend the leg
completely when the thigh is flexed upon the abdomen and the person is sitting or lying
down
Lab tests for viral meningitis (CSF analysis)
✓ ~~~ clear color
increase WBC
, normal or elevated protein content
normal glucose content
negative gram stain
Lab tests for bacterial meningitis (CSF analysis)
✓ ~~~ cloudy color
increase WBC
increase protein content
decrease glucose content
positive gram stain
Nursing actions for lumbar puncture
✓ ~~~ empty bladder
side-lying position
monitor for bleeding,hematoma, infection
medications to treat meningitis
✓ ~~~ Antibiotic
corticosteroid: dexamethasone
Analgesic (acetaminophen with codeine)
dexamethasone
Questions and Answers
Meningitis
✓ ~~~ an inflammation of the CSF and meninges (which are connective tissues that cover
brain and spinal cord).
Reye Syndrome
✓ ~~~ life-threatening disorder that involved acute encephalopathy and fatty changes of the
liver.
Viral (aseptic) meningitis
✓ ~~~ usually requires only supportive care for recovery
Bacterial (septic) meningitis
✓ ~~~ contagious infection; prognosis depends on how quickly care is initiated.
bacterial meningitis risk factors
✓ ~~~ -infections caused by bacterial agents (meningococcoal), streptococcus
pneumoniae, Hib B, e.coli.
-injuries that provide direct access to CSF
-crowded living conditions
viral meningitis risk factors
✓ ~~~ viral illnesses such as:
- mumps
,-herpes simplex virus
-arbovirus
-adenovirus
-cytomegalovirus
Expected findings of meningitis
✓ ~~~ Photophobia
Nausea
Irritability
Headache
newborn findings of meningitis
✓ ~~~ -no illness present at birth
-poor muscle tone,weak cry, poor suck, refuses feeding, and V/D.
-bulging fontanels are late sign.
3 mth to 2 years findings of meningitis
✓ ~~~ seizures with high-pitched cry
fever and irritability
bulging fontanels
possible nuchal rigidity
poor feeding
,2 years through adolescence physical assessment of meningitis
✓ ~~~ seizures (initial sign)
Positive Brudzinski's sign
Positive Kernig's sign
Nuchal rigidity
fever/chills
headache
vomiting
chronic draining ear (with pneumococcal infection)
Petechiae or purpuric-type rash (with meningococcal infection)
Brudzinski's sign
✓ ~~~ pain with resistance and involuntary flex of hip/knee when neck is flexed to chest
when lying supine
Kernig's sign
✓ ~~~ a diagnostic sign for meningitis marked by the person's inability to extend the leg
completely when the thigh is flexed upon the abdomen and the person is sitting or lying
down
Lab tests for viral meningitis (CSF analysis)
✓ ~~~ clear color
increase WBC
, normal or elevated protein content
normal glucose content
negative gram stain
Lab tests for bacterial meningitis (CSF analysis)
✓ ~~~ cloudy color
increase WBC
increase protein content
decrease glucose content
positive gram stain
Nursing actions for lumbar puncture
✓ ~~~ empty bladder
side-lying position
monitor for bleeding,hematoma, infection
medications to treat meningitis
✓ ~~~ Antibiotic
corticosteroid: dexamethasone
Analgesic (acetaminophen with codeine)
dexamethasone
