meningitis
infection of the meninges, the tissues covering brain and spinal cord
types of meningitis
Viral and bacterial (more severe with possible long term complications)
transmission of meningitis
respiratory and throat secretions (coughing, kissing, sharing objects like a glass or cigarette)
Who is most at risk for contracting meningitis?
Children under 5, especially those under age 1, also teenagers and young adults
symptoms of meningitis
High fever, headache, vomiting, body aches progressing to neck stiffness, lethargy, severe headache and convulsions
short and long term complications of meningitis
10% of patients with Meningococcal meningitis will die within 24-48 hours of the onset of symptoms. Of the survivors, 10-20% will have neurological complications such as paralysis, deafness, seizure disorders, mental problems. Other individuals may lose limbs.
Which CBC and spinal fluid parameters are indicative of bacterial meningitis?
WBC is elevated in the CBC. Spinal Fluid: Elevated WBC, protein. Glucose is decreased. Cells and bacteria present in spinal fluid
Why are steroids used to treat patients with meningitis?
reduce inflammation and swelling around the brain, reducing the chance of seizures
What procedure has greatly reduced the incidence of bacterial meningitis?
Vaccination
How long must infectious airborne precautions be maintained after the start of antibiotics?
24 hours
cause of petechial rash in meningitis
Hemorrhage
CT scan
x-ray beams from many different angles are used to create cross-sectional images of the patient's body assembled into a three-dimensional picture.
Why would a physician request a CT scan over an X-ray?
Organs, bones, and tissues can be displayed in great detail in a three-dimensional picture in a CAT scan., while an x-ray is one dimension
Why would an X-ray be ordered over a CT scan?
x-ray picture is all that is needed, more inexpensive
dura mater
superficial layer, composed of dense, irregular connective tissue
arachnoid mater
middle layer, resembles a spider's web of collagen and elastic fibers
Pia Mater
deepest layer, thin transparent connective tissue that adheres to the surface of the spinal cord and brain, supplies oxygen and nutrients to the spinal cord
epidural space
between dura and wall of vertebral canal, composed of fat and connective tissue for protection
subdural space
between dura mater and arachnoid mater, thin layer containing interstitial fluid
subarachnoid space
between arachnoid and pia mater, contains CSF for shock absorption and suspension system for spinal cord and brain
CSF
clear, colorless, liquid that protects the brain and spinal cord from chemical and physical injuries
where is CSF produced?
choroid plexuses
what is the function of CSF?
carries oxygen, glucose, and other needed chemicals from the blood to neurons and neuroglia
How does CSF flow?
lateral ventricles, interventricular foramen, third ventricle, cerebral aqueduct, fourth ventricle, central canal, subarachnoid space, superior sagittal sinus
blood-cerebrospinal fluid barrier
permits certain substances to enter CSF but excludes others, protecting the brain and spinal cord from potentially harmful blood-borne substances
mechanical protection
shock-absorbing to protect brain and spinal cord from hitting walls of cranial cavity and vertebral canal
chemical protection
optimal chemical environment for accurate neuronal signaling, slight changes in CSF can disrupt production of action and postsynaptic potentials
circulation
allows exchange of nutrients and waste products between the blood and nervous system
How does CSF contribute to homeostasis
mechanical and chemical protection, circulation
Name the layers of the meninges from superficial to deep.
dura, arachnoid, and pia mater
Most common causative agent of meningitis in teens
Neisseria meningitis (meningococcal meningitis)
septicemia
bacteria in the blood
normal constituents of CSF
anions, cations, glucose, and WBCs
common meningitis vaccines
Hib, pneumococcal, meningococcal
effect of steroid drugs on acute meningitis
Reduced intracranial pressure
ER nurse
admit patient and administer medications
epidemiologist
notifying school or institutional authorities as to the risks posed by a communicable disease
Medical Laboratory Scientist
responsible for running the tests to detect bacterial meningitis
neurologist
most skills and training to assess the neurological effects of a patient recovering from meningitis
Physician
performs the lumbar puncture
radiology technician
perform an x-ray of the patient's brain assessing the pressure
What is one of the first signs of Disseminated Intravascular Coagulation (DIC)?
Petechial Rash
How can microorganisms gain access to spinal fluid and the meninges
selective permeability through endothelial cells; active transport across border
how powerful is the meningococcal endotoxin?
100 to 10,000x more than other types of bacteria
how do bacterial organisms gain access to the CNS
colonize the nasopharynx, spread to the blood, and make their way to meninges.
WBC
elevated due to the body's response against the bacterial infection
meningitis will present what glucose and proteins CSF levels?
decreased glucose, elevated protein
What would you expect to see in the gram stain?
gram neg diplococcoid bacteria
What happened to intracranial pressure (ICP)?
slightly elevated
why is glucose decreased?
bacterial utilize the CSF glucose
why is the protein increased?
increased cellular matter present