meningitis

Question 1

What are the most common inflammatory conditions of the brain and spinal cord?

Answer 1

Brain abscesses, meningitis, encephalitis.

Question 2

What is meningitis?

Answer 2

Acute inflammation of the meningeal tissues surrounding the brain and spinal cord.

Question 3

What are the causes of meningitis?

Answer 3

Bacteria, viruses, fungi, chemicals.

Question 4

When is meningitis most common?

Answer 4

Fall, winter, early spring.

Question 5

Who is at higher risk for meningitis?

Answer 5

College students (dorms), older adults, institutionalized people (prison, nursing homes, group homes).

Question 6

How is meningitis spread?

Answer 6

Highly spreadable; occurs often when people are in close quarters (e.g., sneezing season).

Question 7

What is the general mortality rate for meningitis?

Answer 7

10–15%; higher in older adults and immunocompromised.

Question 8

What are potential long-term complications of meningitis?

Answer 8

Long-term neurological deficits.

Question 9

Most common bacterial causes of meningitis?

Answer 9

Streptococcus pneumoniae, Neisseria meningitidis (covered in vaccines).

Question 10

How do bacteria enter the CNS?

Answer 10

Via upper respiratory tract, bloodstream, penetrating skull wounds, fractured sinuses, or basilar skull fracture.

Question 11

What does inflammation cause in bacterial meningitis?

Answer 11

↑ CSF production → ↑ ICP; purulent secretions spread through CSF.

Question 12

What happens if infection spreads to brain parenchyma or concurrent encephalitis occurs?

Answer 12

Cerebral edema and significantly ↑ ICP.

Question 13

Key clinical signs of bacterial meningitis?

Answer 13

Fever, severe headache, N/V, nuchal rigidity (physical inability to flex neck).

Question 14

Additional signs of bacterial meningitis?

Answer 14

Photophobia, decreased LOC, signs of ↑ ICP, petechiae (trunk, extremities, mucous membranes).

Question 15

Do viral meningitis symptoms differ from bacterial?

Answer 15

No, symptoms are the same.

Question 16

Diagnostics for bacterial meningitis?

Answer 16

CBC, coag studies, CMP, blood cultures, lumbar puncture (LP) with CSF analysis (protein, WBC, glucose, gram stain, culture), CT head.

Question 17

How is meningitis treated until proven otherwise?

Answer 17

Assume bacterial and treat empirically.

Question 18

Purpose of LP?

Answer 18

Measure ICP; collect CSF for cultures/cytology; infuse chemo, anesthetics, meds; inject contrast for CNS imaging.

Question 19

Nursing role in LP?

Answer 19

Educate, support, prep patient.

Question 20

Position for LP?

Answer 20

Hunched sitting or lying on side bent over (between L3–L4).

Question 21

Post-LP care?

Answer 21

Lie flat at least 60 min; patch site; monitor for CSF leak (headache).

Question 22

Non-pharmacologic treatment for bacterial meningitis?

Answer 22

Rest, IV fluids, hypothermia.

Question 23

Pharmacologic treatment for bacterial meningitis?

Answer 23

IV antibiotics (ampicillin, penicillin, cephalosporin), codeine (HA), dexamethasone (steroid), Tylenol (fever), IV phenytoin (seizure prevention if high risk).

Question 24

Why start antibiotics even if meningitis type is unknown?

Answer 24

If it is bacterial and treatment is delayed, the patient could die

Question 25

Key nursing assessments for bacterial meningitis?

Answer 25

Frequent neuro checks, assess for neuro decompensation/seizures, seizure precautions.

Question 26

Nursing interventions for patient comfort/safety?

Answer 26

Low lighting (photophobia), pain/fever management, antibiotic/steroid administration.

Question 27

Infection control precautions for suspected meningitis?

Answer 27

Droplet precautions; MASK & ISOLATE immediately if suspected.

Question 28

Education points for meningitis?

Answer 28

Vaccine awareness, treat bacterial until proven otherwise.

Question 29

Causes of viral meningitis?

Answer 29

Enteroviruses (e.g., Coxsackie – hand-foot-mouth), HSV, mumps, HIV, varicella-zoster, influenza.

Question 30

Do viral meningitis symptoms differ from bacterial?

Answer 30

No, same symptoms but no bacterial infection (no ↑ WBC).

Question 31

Diagnostics for viral meningitis?

Answer 31

LP, blood tests, PCR (identify virus), CT/MRI.

Question 32

Treatment for viral meningitis?

Answer 32

Mostly symptomatic: hydration, analgesics, antiemetics, rest.

Question 33

When are antivirals used for viral meningitis?

Answer 33

HSV: Acyclovir; HIV: antiretrovirals.

Question 34

What other supportive treatments may be used in viral meningitis?

Answer 34

IV fluids and steroids (for mumps or varicella-zoster).

Question 35

Common causes/associated viruses seen with fungal meningitis?

Answer 35

Enteroviruses, arboviruses, HIV, HSV.

Question 36

Common fungal organisms in meningitis?

Answer 36

Aspergillus, Candida.

Question 37

Clinical manifestations of fungal meningitis?

Answer 37

Same as bacterial meningitis.

Question 38

Diagnostics for fungal meningitis?

Answer 38

H&P, CT/MRI (may show fungal lesions), LP to differentiate cause.

Question 39

Treatment for fungal meningitis?

Answer 39

Antifungal medications.

Question 40

Nursing implications for fungal meningitis?

Answer 40

Same as bacterial meningitis.