Meningitis.pptx

This ppt is related to the Meningitis for nurses. it gives you broad concept of Meningitis definition, types, sign and symptoms, etiology and risk factors, complications, pharmacological management, non pharmacological management, Nursing management, Home care management, concept care Map and quizzes for final evaluation

1. Meningitis

2. Ground rules Be attentive and Listen carefully Don't leave the classroom during presentation Don't create disturbance Switch off cell phones and shut down your laptops Questions and answers will be entertained at the end of presentation

3. Objectives By the end of presentation learners will be able to; To introduce and define the topic. To review the general anatomy of CNS and Meninges To enlist the risk factors and etiology. To explain clinical manifestation and diagnostic evaluation. To elaborate pharmacological and non-pharmacological management and health education of the meningitis. References

4. Brain and Meninges

5. Definition Meningitis is an inflammation of the fluid and membranes (meninges) surrounding your brain and spinal cord.

6. Risk factors Skipping vaccinations. Risk rises for anyone who hasn't completed the recommended childhood or adult vaccination schedule. Age. Most cases of viral meningitis occur in children younger than age 5. ... Living in a community setting. ... Pregnancy. ... Compromised immune system.

7. TYPES OF MENINIGITIS: Viral meningitis Bacterial meningitis Fungal meningitis Parasitic meningitis

8. Etiology Primary --- NIESSIERISA MENINGITIDIS Secondary E-coli Haemophilius influenza Streptococus pneumonia

9. Pathophysiology

10. Clinical manifestation High temperature (fever) Headache. Petechial rashes Neck stiffness. Vomiting and Photophobia may seen. Drowsiness or unresponsiveness. Resistance to the passive extension of the knee with the hip flexed (Kerning Sign). Thigh flexion upon the flexion of neck ( Brudzink’s sign) Acute confusion Seizures (fits) Coma in severe cases

11. Diagnostic Evaluation History taking Physical examination Blood culture CSF analysis CBC, electrolytes level CT scan and MRI Skull X-ray (may demonstrate infected sinuses)

12. Complications Hearing loss Learning disabilities Recurrent seizures (epilepsy) problems with memory and concentration. co-ordination, movement and balance problems Kidney failure Shock Death

13. Management 1- Medical management: A: pharmacological management Antibiotics, penicillin ampicillin and amoxicillin Antiviral: Tenofovir Antifungal: fluconazole Corticosteroids: Dexamethasone I/v Mannitol for diuresis I/v phenytoin Antipyretics: paracetmol

14. Non _ pharmacological management Maintenance of fluid electrolytes balance by i /v therapy Nasogastric tube feeding Vitamin supplementation Head end elevation 30-45 degree Emotional support and necessary information for continuation of care at home, follow up and rehabilitation.

15. Nursing Management Assessment: Obtain history of recent infection such as upper respiratory infection and exposure to causative agents. Assess neurologic status and vital signs. Evaluate for signs of meningeal irritation. Assess vision and hearing loss ,cranial nerve damage (facial nerve palsy) and diminish cognitive functions.

16. Nursing diagnosis Ineffective tissue perfusion ( cerebral) related to infectious process and cerebral edema. Risk for imbalance fluid volume related to fever and decrease intake. Acute pain related to meningeal irritation. Hyperthermia related to the infectious process and cerebral edema. Impaired physical mobility related to prolonged bed rest.

17. Planning To enhance cerebral tissue perfusion To reduce fever To maintain fluid balance To reduce pain To return to optimal level of functioning / mobility.

18. Nursing interventions Enhancing cerebral perfusion Check vital signs and neurologic parameters frequently. Observe for signs and symptoms of ICP (decreased LOC , dilated pupils , widening pulse pressure). Maintain a quiet, calm environment to prevent agitation, which may cause an increased ICP. Prepare patient for a LP for CSF evaluation and repeat spinal tap, if indicated. Notify the health care provider signs of deterioration: increasing temperature, decreasing LOC , seizure or altered respiration. Administer IV mannitol.

19. Reducing fever Administer antibiotics on time to maintain optimal blood levels. Monitor temperature frequently and continuously. Institute other cooling measures, such as hypothermia blanket and taped sponging as indicated. Administer antipyretics as ordered.

20. Maintain Fluid Balance Prevent IV fluid overload , which may worsen cerebral edema. Monitor intake and output closely. Monitor CVP frequently. Administration of osmotic diuretics, Mannitol.

21. Reducing Pain Assess level , intensity, duration & location of pain. Darken the room if photophobia is present. Assist with position of comfort for neck stiffness, and turn patient slowly and carefully with head and neck alignment. Elevate the head of the bed to decrease ICP and reduce pain. Administer analgesics as ordered ; monitor for response and adverse reactions.

22. Promoting return to optimal level of functioning Implement rehabilitation interventions after admission ( e.g 2 hourly positioning). Progress from passive to active exercises based on the patients neurologic status.

23. Expected outcomes Enhanced cerebral tissue perfusion Fluid balance maintained Reduced fever Reduced pain Return to optimal level of functioning

24. meningitis Inflammation of meninges Mostly bacterial Neisseria meningitides Children under age 5yrs & unvaccinated High grade fever Headache Neck stiffness Seizures coma Physical examination (kerning & brudzinski sign positive) CSF analysis CBS CT/MRI Hearing loss Epilepsy Learning disabilities Gait problems Shock death Pharmacological management Antibiotics Antiviral Antipyretics Anticonvulsants Mannitol,diuretics IV fluids therapy Reduce fever Reduce pain Maintain fluid balance Emotional support meningitis

25. Discussion session An acute inflammation of tissue surrounding the brain and spinal cord is called… Brain abscess Meningitis Encephalitis Headache 2) The primary agent of meningitis is… E-coli H. Influenza Neisseria meningitides Streptococcus pneumonia

26. Cont … The less common symptoms of meningitis is… Neck stiffness Headache High grade fever Coma 4) The most significant investigation for meningitis is… CSF analysis Skull x-ray CBC Electrolytes

27. References Basavanthappa , B. T. (2009). Medical surgical nursing (pp. 197-236). Jaypee Bros. Lewis, Sharon Mantik . Lewis's medical-surgical nursing: Assessment and management of clinical problems. Elsevier Australia, 2007. Lippincott manual of nursing practice handbook. Lippincott Williams & Wilkins; 2001. Boyer, M. J. (2010). Brunner and Suddarth's Textbook of Medical-surgical Nursing. Lippincott Williams & Wilkins.