Upgrade to remove ads
Pediatrics ATI meningitis and Reye syndrome
Terms in this set (34)
viral meningitis usually only requires what kind of care for recovery?
Bacterial meningitis is a
contagious infection. Prognosis depends how how quickly care is initiated.
Some risk factors for viral meningitis are..
viral illness, measles, mumps, herpes
Some risk factors for bacterial meningitis are..
upper respiratory infections caused by bacterial agents. immunosuppresion, injuries that provide direct access to cerebrospinal fluid, over crowded living conditions.
Possible symptoms reported by children..
headache or photo phobia. Parents may report child is irritable, has vomited, and is drowsy.
Physical assessment findings of meningitis in newborns.
no illness present at birth but it progresses within a few days. Some clinical signs: poor muscle tone, weak cry, poor feeding. nuchal rigidity is not present. BULGING FONTANELS ARE A LATE SIGN!!
Physical assessment findings of meningitis in the ages 2months-2years.
-seizures with a high-pitched cry
-fever and irritability
-possible nuchal rigidity
-Brudzinski's and Kernig's sign do not assist with Dx
Physical assessment findings of meningitis in children 2years-adolescence
-Positive Brudzinski's and Kernig's sign
-irritability and restlessness that may progress to drowsiness, delirium and stupor or coma.
-petechia or purpuric rash
-chronic draining of ear
What is Brudzinski's sign?
flexion of the extremities occurring with deliberate flexion of the child's neck
What is Kernig's sign?
Resistace to extension of the child's leg from a flexed position.
What are some lab tests that a nurse would expect to be performed?
blood culture and sensitivity test to ID an appropriate broad spectrum antibiotic. Complete blood count (CBC). CSF should be collected.
What are some lab results indicative of meningitis?
CSF that appears cloudy (bacterial) or clear (viral). Elevated WBC, Elevated protein levels, decreased glucose. Elevated CSF pressure.
What is the best diagnostic test for meningitis?
Cerebrospinal fluid analysis.
What are some nursing actions to ensure happen before a CSF sample is taken?
have child empty bladder, place child in the fetal position, assist in maintaining this position, admin prescribed sedatives, appropriately label the 3 test tubes and deliver to lab. monitor site for infection or hematoma
What is some important client education after a CSF sample is taken?
encourage child to lay flat for 4-8 hours to prevent leakage and resulting in a spinal headache.
The presence of petechia or a purpuric-type rash requires
immediate medical attention
What is the first nursing action as soon as meningitis is suspected?
isolation of child.
How long will a child be in isolation?
For 24 hours after first dose of antibiotics has been started.
What are some medications used to treat meningitis?
antibiotics, corticosteroids (decardron), anticonvulsants (Dilantin), analgesics
Increased ICP could lead to..
What are some signs of ICP in infants?
bulging or tense fontanels, increased head circ. high pitched cry, distended scalp veins, irritability, bradycardia
What are some signs of ICP in children?
increased irritability, headache, nausea, vomiting, diplopia, seizures, bradycardia, respiratory changes
What are some interventions to reduce ICP?
positioning, avoidance of coughing, straining, and bright lights, reduce environmental stimuli.
What organs does Reye syndrome mostly effect?
the liver and brain
Reye syndrome can cause...
liver dysfunction, cerebral edema, hypoglycemia, shock
Reye syndrome presents in how many different stages?
5. each stage having new symptoms and continuing with the previous symptoms.
Stage 1 of Reye syndrome manifestations:
lethargy, vomiting, anorexia, early liver dysfunction, brisk pupillary reaction, ability to follow commands.
Stage 2 of Reye syndrome manifestations:
confusion/disorientation/delirium, hyperactive reflexes, sluggish pupillary response, response to painful stimuli.
Stage 3 of Reye syndrome manifestations:
coma, seizures, flexion rigidity
Stage 4 of Reye syndrome manifestations:
deeper coma, extension rigidity, fixed large pupils and loss of corneal reflex, brain stem dysfunction, minimal liver dysfunction
Stage 5 manifestations of Reye syndrome:
hypotonia, seizures, respiratory arrest, absence of liver dysfunction
What are some lab tests expected with Reye syndrome?
liver enzymes, serum ammonia level, serum electrolytes, serum blood glucose, CBC
coagulation times may be extended.
What are some nursing care actions to take?
maintain hydration, position child to avoid extreme flexion, extension and rotation, maintain head midline, keep hob elevated @least 30 degrees, monitor coagulation, take seizure precautions, contact support for the family.
What are some medications used to treat Reye Syndrome?
osmotic diuretic, insulin
THIS SET IS OFTEN IN FOLDERS WITH...
Pediatrics ATI 3-6 years
Pediatrics ATI seizures and head injuries
Pediatrics ATI death and dying
YOU MIGHT ALSO LIKE...
ATI Chapter 12 Meningitis
Peds ATI Ch. 12 (Acute Neurological Disorders)
FINAL: Pediatric Neurological Problems
OTHER SETS BY THIS CREATOR
Peds ATI hospitalization, illness, and play
Pediatrics ATI pain management
Pediatrics ATI safe admin of meds