Meningitis

meningitis ( inflammation of meninges)

1. MENINGITIS
PRESENTED BY
PANKAJ SINGH RANA
NURSE PRACTITIONER
SRHU

2. DEFINITION
It is inflammation of the protective
membranes covering the brain and
spinal cord collectively known as
meninges.
Neonate develop meningitis as result of
Escherichia coli, hemophilus influenza ,
type B streptococcus pneumonia,
Neisseria meningitis , streptococcus
pneumonia and herpes

3. FacTs
If there is infection of CSF there will be
infection of meninges
Tumors , medication ,and chemical exposure
can also cause meningitis
Most people are affected with viral meningitis
than bacterial meningitis
95 % of meningitis is occurring in children
below 5 year

4. caUsEs
Viruses.
Bacteria's.
Certain drugs.
Fungi.
Parasites.
Toxins.
Malignancies.
Sarcoidosis.

5. TypEs
Pyogenic or bacterial meningitis
Viral meningitis ,fungal / aseptic
meningitis
Tuberculous meningitis

6. pyOgENIc mENINgITIs
Pyogenic meningitis is caused by
bacterial infection

7. ETIOlOgy
The children beyond 3 year are having meningitis
caused by the pneumococci.
Age -: all age group
Mode of transmission -: spread through
respiratory and throat secretion ,saliva

8. paThOphysIOlOgy

9. clINIcal maNIFEsTaTIONs

10. CLINICAL MANIFESTATIONS
 vomiting.
Headache
 High Fever
Malaise
Restlessness
Irritability
convulsion

11. On examination
 papilledema
Positive Brudzinski sign
 positive Kernig sign
Diopia( double vision)
Nuchal stiffness
 cranial nerve palsy

15. COMPLICATIONS:-
Brain damage.
myocarditis
Hydrocephalus.
 brain abscess
Convulsive disorder

16. DIAgNOSTIC EvALuATION
CSF examination
Blood culture
Urine analysis
X-Ray
CT scan

17. management

18. Pyogenic meningitis should be considered as
medical emergency and following measures
should be initiated
The commonly used drug are penicillin 4 to 5
lac unit/kg/4 hourly or cefoaxime 200mg/kg/day
and hourly iv
Ampicillin , gentamicin, amikacin also used
Antibiotics can be given intrathecal in
neonatal meningitis

19. Corticosteroids , dexamethasone 0.15mg/kg
every 6 hourly iv in severely ill patient with
shock and to prevent neurological complication
Anticonvulsive drug diazepam 0.3 mg to
manage convulsions

20. Prognosis
Prognosis depend upon initiation of early
treatment diagnosis. Generally patient with
bacterial meningitis show distinct
improvement 10-15 days with appropriate anti
microbial drugs
delayed starting of management may lead to
serious neurological complication

21. Tuberculous meningiTis
Tuberculous meningitis is the inflammation
of the meninges from tubercular infection
caused by mycobacterium tuberculosis . It
have serious complication of childhood
tuberculosis

22. clinical manifesTaTion
It is divvied into three stages i.e.
Prodromal, transitional and terminal
prodromal stage
Anorexia
Apathy
Drowsiness
Disturb sleep
Headache
Restlessness
Loss od weight
Sometime convulsion

23. Transitional stage
Fever
Bradycardia
Headache
Delirium
Hemiplegia
Terminal stage
Fever
Irregular respiration and Bradycardia
Hydrocephalus may also develop

24. DiagnosTic evaluaTion
History collection
Physical examination
CSF study (inc. CSF pressure)
Ct scan
MRI
Blood examination

25. managemenT
Anti tuberculosis medication is provided
rifampicin , pyrazinamide. Streptomycin or
enthambutol for two month
Anticonvulsant therapy
Corticosteroid therapy should be provided

26. comPlicaTion
Hydrocephalus most common
Mental retardation
Convulsive disorder
Neurological deficit
Visual complication

27. asePTic meningiTis
Aseptic meningitis is define as inflammation of
the covering layer of brain by fungi, protozoa
Clinical manifestation
Shortness of breathing
Irritability
Feeding difficulty
fever

28. Diagnostic evaluation
Blood test
Physical examination
X ray
CT scan ( to find any area of swelling and
inflammation)
Csf examination

29. complication
Brain damage
Subdural effusion
Hydrocephalus
Seizure
Hypertensive coma
Hemiparesis
dysphagia

30. manaGEmEnt:-
Antibiotics e.g.; penicillin, cephalosporin.
Codeine for headache.
Dexamethasone.
Acetaminophen or aspirin for high fever.
Phenytoin.
Mannitol.
Clear liquids as tolerated.
I/V fluids.
Bed rest.

31. NURSING MANAGEMENT:-
Nursing Assessment:-
History.
Physical examination.
Assess vital signs.
Monitor input-output of the patient.

32. NURSING DIAGNOSIS:-
Disturbed sensory perfusion related to altered cognitive
function.
NURSING GOALS:-
Demonstrates appropriate cognitive function.
Is oriented to time, place & person.
NURSING INTERVENTION:-
1.Assess the neurological status of the patient.
2.Administer medications to reduce anxiety.
3.Provide a low stimulation environment.
4.Approach patient slowly & from the front.
5.Reorient the patient to the health care provider with each
contact.

33. NURSING DIAGNOSIS:-
Acute pain related to headache & muscle spasms.
NURSING GOAL:-
Reports satisfaction with pain control.
NURSING INTERVENTION:-
1.Administer analgesics.
2. Select & implement pain management strategies
other than analgesics.
3. Reduce or eliminate aggravating factors.
4. Provide calm & quite environment.

34. NURSING DIAGNOSIS:-
Hyperthermia related to infection.
NURSING GOAL:-Experiences normal body
temperature.
NURSING INTERVENTION:-
1.Frequently monitor vital signs.
2.Monitor input & output of patient.
3.Assess level of consciousness of the patient.
4.Encourage liberal fluids.
5.Cold sponging
6.Cold saline lavage

35. NURSING DIAGNOSIS:-
Potential for seizure activity related to cerebral irritation.
NURSING GOAL:-
Reports less or no seizure activity.
NURSING INTERVENTION:-
1.Monitor & record seizure.
2.Prevent from tongue bite and aspiration by lateral
position.
3.Take seizure precaution.
4.Administer anti-seizure drug.
5.Eliminate & prevent precipitating factors.

36. Thank u………