Professional Documents
Culture Documents
L
E
A W
R H
N I
I T
N L E
G I
S B
C T O
U E A
M N R
I D
D N
I G &
S
Scans of the head may show swelling or C P
U P
inflammation. S T
X-rays or CT scans of the chest or sinuses S
I
also may show infection in other areas that O
may be associated with meningitis. N
Spinal tap (lumbar puncture).
For a
definitive
diagnosis of
meningitis, L
E
you'll need a
A
spinal tap to collect R W
N H
cerebrospinal fluid
I I
(CSF). N L T
G I E
In people with meningitis, the CSF often
S
shows a low sugar (glucose) level along C T B
U E O
with an increased white blood cell count and
M N A
increased protein. I R
D N D
CSF analysis may also help doctor identify
I G
which bacterium caused the meningitis. S &
C
If the doctor suspects viral meningitis, he or
U P
she may order a DNA-based test known as a S P
S T
polymerase chain reaction (PCR)
I
amplification or a test to check for O
N
antibodies against certain viruses to
determine the specific cause and determine
proper treatment.
TREATMENT
The treatment depends on the type of
L
meningitis the person has. E
A W
Bacterial meningitis:
R H
Acute bacterial meningitis must be treated N I
I T
immediately with intravenous antibiotics
N L E
and sometimes corticosteroids. This helps G I
S B
to ensure recovery and reduce the risk of
C T O
12 complications, such as brain swelling and U E A
M N R
state the seizures. explain the
4 min I D
management The antibiotic or combination of antibiotics D N management of
of meningitis I G & meningitis
depends on the type of bacteria causing the
S
infection. Doctor may recommend a broad- C P
U P
spectrum antibiotic until he or she can
S T
determine the exact cause of the meningitis. S
I
Doctor may drain any infected sinuses or
O
mastoids — the bones behind the outer ear N
that connect to the middle ear.
Viral meningitis:
Antibiotics can't cure viral meningitis, and
most cases improve on their own in several L
E
weeks. Treatment of mild cases of viral
A
meningitis usually includes: R W
N H
- Bed rest
I I
- Plenty of fluids N T
G L E
- Over-the-counter pain medications to
I
help reduce fever and relieve body aches C S B
U T O
Doctor may prescribe corticosteroids to
M E A
reduce swelling in the brain, and an N R
D I D
anticonvulsant medication to control
I N
seizures. If a herpes virus caused S G &
C
meningitis, an antiviral medication is
U P
available. S P
S T
Other types of meningitis
I
If the cause of your meningitis is unclear, O
N
doctor may start antiviral and antibiotic
treatment while the cause is determined.
Treatment for chronic meningitis is based
on the underlying cause. Antifungal
medications treat fungal meningitis, and a
combination of specific antibiotics can treat
tuberculous meningitis. However, these
medications can have serious side effects,
so treatment may be deferred until a
laboratory can confirm that the cause is
fungal.
Non-infectious meningitis due to allergic
reaction or autoimmune disease may be
treated with corticosteroids. In some cases,
no treatment may be required because the
condition can resolve on its own. Cancer-
related meningitis requires therapy for the
specific cancer.
MANAGEMENT
Medical Management
• Vancomycin hydrochloride in
combination with one of the
cephalosporins (eg, ceftriaxone sodium,
cefotaxime sodium) is administered by
intravenous (IV) injection.
13 • Dexamethasone (Decadron) has been
shown to be beneficial as adjunct therapy explain the
2 min list out the complications
complications in the treatment of acute bacterial of meningitis
of meningitis
meningitis and in pneumococcal
meningitis.
• Dehydration and shock are treated with
fluid volume expanders.
• Seizures, which may occur early in the
course of the disease, are controlled with
phenytoin (Dilantin).
• Increased ICP is treated as necessary.
Nursing Management
• Prognosis depends largely on the
supportive care provided. Related nursing
interventions include the following:
• Assess neurologic status and vital signs
constantly. Determine oxygenation from
arterial blood gas values and pulse
oximetry.
• Insert cuffed endotracheal tube (or
tracheostomy), and position patient on
mechanical ventilation as prescribed.
• Assess blood pressure (usually monitored
using an arterial line) for incipient shock,
which precedes cardiac or respiratory
failure.
• Rapid IV fluid replacement may be
prescribed, but take care not to
overhydrate patient because of risk of
cerebral edema.
• Reduce high fever to decrease load on
heart and brain from oxygen demands.
• Protect the patient from injury secondary
to seizure activity or altered level of
consciousness (LOC).
• Monitor daily body weight; serum
electrolytes; and urine volume, specific
gravity, and osmolality, especially if
syndrome of inappropriate antidiuretic
hormone (SIADH) is suspected.
• Prevent complications associated with
immobility, such as pressure ulcers and
pneumonia.
• Institute infection control precautions
until 24 hours after initiation of antibiotic
therapy (oral and nasal discharge is
considered infectious).
• Inform family about patient’s condition
and permit family to see patient at
appropriate intervals.
COMPLICATIONS
- seizures
- hearing loss
- vision loss
- memory problems
- arthritis
- migraine headaches
- brain damage
- kidney failure
- hydrocephalus
- a subdural empyema, or a buildup of
fluid between the brain and the skull
A meningitis infection may produce
bacteria in the bloodstream. These
bacteria multiply and some release
toxins. That can cause blood vessel
damage and leaking of blood into the
skin and organs.
A serious form of this blood infection
can be life-threatening. Gangrene may
damage skin and tissue. In rare cases,
amputation may be necessary. Several
other serious complications may occur in
people with meningitis.
SUMMARY