Term
| What are the 3 components and percentages that occupy the skull? |
|
Definition
brain tissue - 78%
cerebral blood flow - 12%
CSF - 10% |
|
|
Term
| What are the 6 factors that influence ICP under normal circumstances? |
|
Definition
1. arterial pressure
2. venous pressure
3. intraabdominal pressure
4. posture
5. temperature
6. blood gases, esp. CO2 |
|
|
Term
| What 5 areas of the brain allow for measure of ICP? |
|
Definition
1. ventricles
2. subarachnoid space
3. subdural space
4. epidural space
5. brain tissue |
|
|
Term
| What is used to measure ICP? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| The body's initial compensation mechanisms for increased ICP are extensive. True or False? |
|
Definition
| False, these mechanisms are limited |
|
|
Term
| How is cerebral blood flow measured? |
|
Definition
| the amount of blood in mLs that passes through 100g of brain tissue in 1 min |
|
|
Term
| What is the normal global CBF? |
|
Definition
| 50mL/min in 100g brain tissue |
|
|
Term
| What is the normal CBF of white matter? |
|
Definition
| 25mL/min per 100g brain tissue |
|
|
Term
| What is the normal CBF of gray matter? |
|
Definition
| 75mL/min per 100g brain tissue |
|
|
Term
| What percent of the body's oxygen and glucose does the brain use? |
|
Definition
oxygen - 20%
glucose - 25% |
|
|
Term
| In what range must MAP be maintained for autoregulation of CBF to continue? |
|
Definition
|
|
Term
| What is cerebral perfusion pressure (CPP)? |
|
Definition
| the pressure needed to ensure blood flow to the brain |
|
|
Term
| What is the equation for finding CPP? |
|
Definition
|
|
Term
| What is the equation for finding MAP? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Below what CPP does ischemia and neuronal death occur? |
|
Definition
|
|
Term
| Below what CPP can life no longer be supported? |
|
Definition
|
|
Term
| When does Cushing's triad occur? |
|
Definition
| with a loss of autoregulation when decompensation is occuring |
|
|
Term
| What are the parts of Cushing's triad? |
|
Definition
| increase in systolic BP with widening pulse pressure, bradycardia with a bounding pulse, altered respirations |
|
|
Term
| What happens to CBF and ICP with an increase in PaCO2? |
|
Definition
| increase in PaCO2 would increase CBF which would increase ICP |
|
|
Term
| What happens to CBF and ICP with a decrease in PaCO2? |
|
Definition
| decrease in PaCO2 would decrease CBF which would decrease ICF |
|
|
Term
| By what 3 mechanisms does an increase in PaCO2 lead to an increase in CBF? |
|
Definition
1. relaxes smooth muscle
2. dilates cerebral vessels
3. decreases cerebrovascular resistance |
|
|
Term
| What fatal response will occur if pressure on the brain stem is unrelieved? |
|
Definition
| respiratory arrest d/t compression of the respiratory control center in the medulla |
|
|
Term
|
Definition
| increased accumulation of fluid in the extravascular space of the brain tissue |
|
|
Term
| What is edema caused by changes in the endothelial lining of cerebral capillaries that allow leakage of macromolecules from the capillaries into the surrounding extracellular space? |
|
Definition
|
|
Term
| What 3 factors influence the speed and extent of spread of cerebral edema? |
|
Definition
1. systemic BP
2. site of brain injury
3. extent of blood-brain barrier defect |
|
|
Term
| In cases of cerebral edema a headache is a mild symptom with no immediate threat of harm. True or False? |
|
Definition
| False, in cases of cerebral edema a headache can quickly progress to coma or death |
|
|
Term
| This type of cerebral edema results from local disruption of the functional or morphologic integrity of cell membranes. |
|
Definition
|
|
Term
| This type of cerebral edema results from a rupture of the CSF brain barrier and is usually a result of obstructive or uncontrolled hydrocephals. |
|
Definition
| interstitual cerebral edema |
|
|
Term
| What are the 2 treatments of hydrocephalus? |
|
Definition
| ventriculostomy and shunt |
|
|
Term
| Where does enlargement occur in cases of hydrocephalus? |
|
Definition
|
|
Term
| What are the 3 probable causes of hydrocephalus? |
|
Definition
1. excess CSF production
2. obstruction of flow
3. inability to reabsorb the CSF |
|
|
Term
| What is the most sensitive and reliable indicator of the patient's neuro status? |
|
Definition
|
|
Term
| Changes in LOC are a result of impaired CBF which deprives the cells of what of oxygen? |
|
Definition
| cerebral cortex and reticular activating system (RAS) |
|
|
Term
| An intact ________ can maintain a state of wakefulness even in the absence of a functioning cerebral cortex. |
|
Definition
| reticular activating system (RAS) |
|
|
Term
| Is Cushing's triad considered a medical emergency? What is it a sign of? |
|
Definition
| yes; it is a sign of brainstem compression and impending death resulting from excessive increased ICP |
|
|
Term
| If the pupils are unilaterally dilated what does this indicate? |
|
Definition
|
|
Term
| What is the initial pupil response with cerebral herniation? |
|
Definition
|
|
Term
| What type of hemiparesis will be noted in the pt with increased ICP contralateral or ipsilateral? |
|
Definition
|
|
Term
| Which posture indicates brain stem damage and is considered the worst? |
|
Definition
| decerebrate, the wrist are flexed outwardly with pointed toes |
|
|
Term
| What is the distinguishing factor of vomiting r/t increased ICP? |
|
Definition
| it is not preceded by nausea |
|
|
Term
| What are the 2 major complications of uncontrolled increasing ICP? |
|
Definition
| inadequate cerebral perfusion and cerebral herniation |
|
|
Term
| Which 2 tests are used to differentiate the many conditions that cause increased ICP and evaluate therapeutic options? |
|
Definition
|
|
Term
| Why is a lumbar puncture generally not performed on the pt with increased ICP? |
|
Definition
| the risk of cerebral herniation d/t the rapid release of pressure above the site of the LP |
|
|
Term
| At or below what Glascow Coma score should ICP monitoring be initiated if not already? |
|
Definition
|
|
Term
| What is the "gold standard" for ICP monitoring? |
|
Definition
|
|
Term
| What is a ventriculostomy? |
|
Definition
| a specialized catheter is inserted into the lateral ventricle and coupled to an external transducer |
|
|
Term
| What 3 functions does a ventriculostomy perform? |
|
Definition
1. ICP monitoring
2. drainage of excess CSF
3. intraventricular drug administration |
|
|
Term
| What part of the ventriculostomy is leveled with what part of the body? |
|
Definition
| the transducer is leveled with the foramen of Monro |
|
|
Term
| What is a reference point for the foramen of Monro? |
|
Definition
|
|
Term
| If a CSF drainage device is in place how long must it be closed prior to taking an ICP reading? |
|
Definition
|
|
Term
| What should the nurse do if an increase is noted in the mean ICP pressure or if an abnormal waveform is noted? |
|
Definition
|
|
Term
| How does the nurse know when to begin intermittent CSF drainage? |
|
Definition
| physician will write the order at what ICP level to begin CSF drainage |
|
|
Term
| When ICP reaches the ordered level for CSF drainage, what is the procedure the nurse will follow with the ventriculostomy? |
|
Definition
| open the stopcock for 2-3 mins to allow drainage then close the stopcock |
|
|
Term
| Why is it recommended to have a sign posted in the room of a pt on a CSF drainage device? |
|
Definition
| if the pt is turned or anything is done that will increase ICP while the drain is draining it will remove too much CSF too quickly |
|
|
Term
| What 2 things does the LICOX system monitor? |
|
Definition
| continuous monitoring of pressure of oxygen in brain tissue and measures brain temperature |
|
|
Term
| What is the normal range for pressure of oxygen in brain tissue? |
|
Definition
|
|
Term
| If the pt with increased ICP is intubated what should the goal be for both the PaO2 and PaCO2? |
|
Definition
|
|
Term
| What is the best treatment, if possible, for increased ICP d/t a mass or tumor? |
|
Definition
|
|
Term
| What are 2 possible treatments to reduce cerebral tissue in cases of swelling or edema? |
|
Definition
| diuretics and corticosteroids |
|
|
Term
|
Definition
|
|
Term
| How does Mannitol decrease ICP? |
|
Definition
| plasma expansion and osmotic effect which decreases the total brain fluid content |
|
|
Term
| What can be used with or instead of Mannitol in cases of increased ICP? |
|
Definition
|
|
Term
| Corticosteroids are used to treat vasogenic edema surrounding tumors and abscesses. When is the use of steroids contraindicated? |
|
Definition
|
|
Term
| What are 3 complications of taking corticosteroids? |
|
Definition
1. hyperglycemia
2. increased incidence of infections
3. GI bleed |
|
|
Term
| What should also be given if a pt is taking corticosteroids? |
|
Definition
| an H2 receptor blocker (Zantac), PPI (Protonix), or antacid to prevent ulcer or GI bleed |
|
|
Term
| What happens to ICP as metabolic demands increase (fever, shivering, agitation, seizures)? |
|
Definition
|
|
Term
| What classification of medicine is used to decrease cerebral metabolism, causing a decrease in ICP as well as a reduction in cerebral edema? |
|
Definition
| high doses of barbiturates (pentobarbital, thiopental) |
|
|
Term
| What is barbiturate dosing based on when used to treat increased ICP? |
|
Definition
| bedside EEG tracing and ICP |
|
|
Term
| Why does the pt with increased ICP require increased glucose? |
|
Definition
| because the increased ICP causes a hypermetabolic and hypercatabolic state |
|
|
Term
| How soon after injury should the pt with increased ICP be started on nutritional replacement? When should they be at full nutritional replacement? |
|
Definition
|
|
Term
| What are the most vital systems that need to be assessed initially in the pt with increased ICP? |
|
Definition
| respiration and circulation |
|
|
Term
| Which three factors are evaluated with the Glascow Coma Scale? |
|
Definition
1. opening of eyes
2. best verbal response
3. best motor response |
|
|
Term
| What is the highest possible Glascow Coma Score? |
|
Definition
|
|
Term
| What is the lowest possible Glascow Coma Score? |
|
Definition
|
|
Term
| At or below what number generally indicates coma in the Glascow Coma Scale? |
|
Definition
|
|
Term
| If the oculomotor nerve (III) is compressed what happens to the ipsilateral pupil? |
|
Definition
| becomes larger until if fully dilates |
|
|
Term
| What pupil characteristic is indicative of early pressure on CN III? |
|
Definition
|
|
Term
| What does a pupil that is unresponsive to light and stimulus usually indicate? |
|
Definition
|
|
Term
| How does the RN test eye movements of the unconscious pt? |
|
Definition
doll's eye reflex
-turn the pt's head briskly right or left while holding the eyelids open, a normal response is movement of the eyes in the opposite direction of the head being turned |
|
|
Term
| How is pain response checked in the unconscious pt? |
|
Definition
| pressure applied to the finger nail bed |
|
|
Term
| What are 2 things that put the unconscious pt at risk of aspiration? |
|
Definition
1. tongue falling to back of mouth
2. excessive secretions |
|
|
Term
| At what Glascow Coma Score is intubation generally indicated? |
|
Definition
|
|
Term
| For the pt with increased ICP, what degree should the head of the bed be? |
|
Definition
|
|
Term
| What are the guidelines for suctioning the pt with increased ICP? |
|
Definition
-only PRN and as little as possible
-less than 10 secs at a time
-administer 100% O2 before and after each pass
-limit to two passes per procedure |
|
|
Term
| What must CPP be kept above to preserve cerebral perfusion? |
|
Definition
|
|
Term
| Which nursing intervention may interfere with the neurological assessment of the pt? |
|
Definition
|
|
Term
| What advantages does morphine and fentanyl have for use with the pt with increased ICP? |
|
Definition
| minimal effect on CBF or oxygen metabolism |
|
|
Term
| What advantage does the sedative propofol have when used for agitation in the pt with increased ICP? |
|
Definition
| it has a rapid onset and short half-life so neuro checks can be done shortly after pausing the infusion |
|
|
Term
| Why are benzodiazepines usually avoided in pts with increased ICP? |
|
Definition
| because they have a long half-life and have a hypotensive effect |
|
|
Term
| What should be suspected if the pt with increased ICP shows signs of increased UOP and hypernatremia? |
|
Definition
|
|
Term
| What is the treatment for Diabetes insipidus? |
|
Definition
| fluid replacement and vasopressin or DDAVP |
|
|
Term
| What should be suspected if the pt with increased ICP shows signs of decreased UOP and hyponatremia? |
|
Definition
|
|
Term
| What complications can follow SIADH? |
|
Definition
| cerebral edema, LOC changes, seizures, coma |
|
|
Term
| What effect does Valsalva maneuver, coughing, sneezing, hypoxemia, and waking from sleep have on ICP? |
|
Definition
|
|
Term
| The HOB should be elevated to 30 degrees for the pt with increased ICP, why should extreme neck flexion be avoided? |
|
Definition
| extreme neck flexion can cause venous obstruction which could elevate ICP |
|
|
Term
| What may occur if the HOB of a pt with increased ICP is raised above 30 degrees? |
|
Definition
| CPP may decrease d/t a lowered systolic BP |
|
|
Term
| At what 3 time points are pts with head trauma at risk for death? |
|
Definition
1. at the time of injury
2. within 2 hrs after injury
3. approximately 3 weeks s/p injury |
|
|
Term
| What causes immediate death of pts with head injury? |
|
Definition
| direct trauma or massive hemmorrhage and shock |
|
|
Term
| What causes death of pts with head injury in the first 2 hrs? |
|
Definition
| progressive worsening of the injury or internal bleeding |
|
|
Term
| What causes death of pts with head injury at 3 wks s/p injury? |
|
Definition
|
|
Term
| Why is the pt with a scalp laceration at a risk for profuse bleeding? |
|
Definition
| the scalp contains many blood vessels with poor constrictive ability |
|
|
Term
| What is rhinorrhea or otorrhea indicative of for the pt suffering a head injury? |
|
Definition
| that the fracture has transversed the dura |
|
|
Term
| Why should the pt with a CSF leak be started on antibiotics? |
|
Definition
| d/t the increased risk for meningitis |
|
|
Term
| What are the 2 ways to test leaking fluid to see if it is CSF? |
|
Definition
1. test for glucose
2. test for halo sign |
|
|
Term
|
Definition
| halo sign appears if CSF is placed on a white gauze and the blood will form an inner circle and a yellowish ring encircles the blood |
|
|
Term
| What type of skull fracture is a break in continuity of bone without alteration of relationship of parts? |
|
Definition
|
|
Term
| What type of skull fracture is an inward indentation of the skull? |
|
Definition
|
|
Term
| What type of skull fracture is a linear or depressed fracture without fragmentation or communicating lacerations? |
|
Definition
|
|
Term
| What type of skull fracture has multiple linear fractures with fragmentation of bone into many pieces? |
|
Definition
|
|
Term
| What type of skull fracture is a depressed fracture with communicating pathway to intracranial cavity? |
|
Definition
|
|
Term
| Raccoon eyes are indicative of? |
|
Definition
|
|
Term
| Battle's sign is indicative of what 3 possible skull fractures? |
|
Definition
1. temporal fracture
2. parietal fracture
3. basilar fracture |
|
|
Term
| What Glascow Coma Score range indicates minor brain injury? |
|
Definition
|
|
Term
| What Glascow Coma Score range indicates moderate brain injury? |
|
Definition
|
|
Term
| What Glascow Coma Score range indicates severe brain injury? |
|
Definition
|
|
Term
| What are the usual S&S of concussion? |
|
Definition
| brief disruption in LOC, amnesia regarding the event, and HA. Symptoms are usually brief |
|
|
Term
| When is postconcussion syndrome usually seen? |
|
Definition
| 2 wks - 2 months s/p concussion |
|
|
Term
| What are the S&S of postconcussion syndrome? |
|
Definition
-persistent HA
-lethargy
-personality/behavioral changes
-shortened attention span
-decreased short term memory |
|
|
Term
| What are the 4 types of focal brain injury? |
|
Definition
1. lacerations
2. contusions
3. hematomas
4. cranial nerve injuries |
|
|
Term
| What is an actual tearing of the brain tissue? |
|
Definition
|
|
Term
| Can a brain laceration be surgically repaired? |
|
Definition
| no, d/t the nature of brain tissue |
|
|
Term
| How is a brain laceration treated? |
|
Definition
| prophylactic antibiotics until meningitis is ruled out; treatment of secondary increased ICP |
|
|
Term
| What are the S&S of a space occupying cerebral hemorrhage? |
|
Definition
| unconsciousness, hemiplegia on the contralateral side, dilated pupil on the ipsilateral side |
|
|
Term
| Bruising of the brain tissue within a focal area is? |
|
Definition
|
|
Term
| What is the coup / contrecoup injury? |
|
Definition
coup - injury to the brain that occurs at the site of impact
contrecoup - rebound injury that occurs on the opposite side of the brain from impact |
|
|
Term
| A hematoma that occurs between the dura and the inner surface of the skull is a? |
|
Definition
|
|
Term
| Is an epidural hematoma a neurologic emergency? |
|
Definition
|
|
Term
| What is the difference in progression of a venous / arterial epidural hematoma? |
|
Definition
-venous occur slowly under low pressure
-arterial occur rapidly under high pressure |
|
|
Term
| What are the classic signs of an epidural hematoma? |
|
Definition
| initial period of unconsciousness at the scene, followed by a brief lucid interval followed by a decrease in LOC |
|
|
Term
| What must be done quickly to prevent herniation in the pt with an epidural hematoma? |
|
Definition
| evacuation of the hematoma |
|
|
Term
| What type of hematoma occurs between the dura mater and the arachnoid layer? |
|
Definition
|
|
Term
| What is the normal rate of progression of a subdural hematoma? |
|
Definition
| subdural hematoma is usually venous in origin so it usually develops slowly |
|
|
Term
| What are the 3 types of subdural hematoma? |
|
Definition
1. acute
2. subacute
3. chronic |
|
|
Term
| What is the time frame for an acute subdural hematoma? |
|
Definition
| 24-48 hrs s/p severe trauma |
|
|
Term
| What is the time frame for a subacute subdural hematoma? |
|
Definition
| 48 hrs - 2 wks s/p severe trauma |
|
|
Term
| What is the time frame for a chronic subdural hematoma? |
|
Definition
| weeks to months s/p injury; generally greater than 20 days and injury may have seems minor at the time |
|
|
Term
| How soon are symptoms seen with an acute subdural hematoma? |
|
Definition
|
|
Term
| What is the treatment for a subdural hematoma? |
|
Definition
| evacuation and decompression |
|
|
Term
| Why are older pts and alcoholics more prone to subdural hematoma? |
|
Definition
| old age and alcoholism causes brain atrophy which causes a larger subdural space |
|
|
Term
| Is a hematoma that occurs from bleeding within the brain tissue? |
|
Definition
|
|
Term
| What is the best diagnostic test to evaluate head trauma rapidly? |
|
Definition
|
|
Term
| What treatment is necessary for depressed fractures and fractures with loose fragments? |
|
Definition
|
|
Term
| What technique is the removal of a section of the skull? |
|
Definition
|
|
Term
| What is the treatment for large hematomas? |
|
Definition
|
|
Term
| What is the technique for surgical evacuation? |
|
Definition
| craniotomy is performed to visualize the hematoma, Burr-hole openings may be used for rapid decompression, for extreme hematoma craniectomy may be necessary |
|
|
Term
| Doing what would reduce the greatest risk for head injury? |
|
Definition
|
|
Term
| What is the general goal of nursing management of the head injured pt? |
|
Definition
| maintain cerebral oxygenation and perfusion |
|
|
Term
| What is the treatment of diplopia? |
|
Definition
an eyepatch
(diplopia = double vision) |
|
|
Term
| Periorbital ecchymosis resolves on its on, what can hasten this progress? |
|
Definition
| cold then warm compresses |
|
|
Term
| What is the most vulnerable time for seizures to occur following a head injury? |
|
Definition
|
|
Term
| Why is Dilantin typically used s/p head trauma? |
|
Definition
| prophylactic seizure measure |
|
|
Term
| Pts with head injury who have been unconscious for 6 hrs or more will typically display what when they awaken? |
|
Definition
|
|
Term
| How long s/p head trauma can progressive recovery continue until a plateau is reached? |
|
Definition
|
|
Term
| What are some of the "no" policies that a physician may prescribe for the head trauma pt at discharge? |
|
Definition
NO...
-drinking alcohol
-driving
-us of firearms
-work with hazardous implements/machinery
-unsupervised smoking |
|
|
Term
| What determines which S&S are apparent with a brain tumor? |
|
Definition
| size and location of the tumor |
|
|
Term
| A brain tumor that obstructs the ventricle or occludes the outlet can lead to what? |
|
Definition
|
|
Term
| When do tumor related HAs tend to be worse? |
|
Definition
|
|
Term
| Are lumbar punctures generally performed r/t brain tumors? |
|
Definition
| no; d/t risk of herniation |
|
|
Term
| What tissue does Glioblastoma multiforme originate from? |
|
Definition
|
|
Term
| What are the characteristics of Glioblastoma multiforme? |
|
Definition
| highly malignant and invasive; among the most devastating of primary brain tumors |
|
|
Term
| What is the tissue of origin Hemangioblastoma? |
|
Definition
|
|
Term
| What are the characteristics of Hemangioblastoma? |
|
Definition
| rare and benign; surgery is curative |
|
|
Term
| What is the tissue of origin of metastatic tumors? |
|
Definition
| lungs, breast, kidney, thyroid, prostate, etc |
|
|
Term
| What are the characteristics of metastatic tumors? |
|
Definition
|
|
Term
| What location would the tumor be of a pt exhibiting unilateral hemiplegia, seizures, memory deficit, personality and judgement changes, and visual disturbances? |
|
Definition
|
|
Term
| What would the location be of a tumor if the pt exhibits speech disturbances, inability to write, spatial disorders, unilateral neglect? |
|
Definition
|
|
Term
| What location would the tumor be if the pt exhibited vision disturbances and seizures? |
|
Definition
|
|
Term
| What location would the tumor be if the pt exhibited few symptoms possible seizures and dysphagia? |
|
Definition
|
|
Term
| What location would the tumor be if the pt exhibited HA on awakening, drowsiness, vomiting, ataxic gait, facial muscle weakness, hearing loss, dysphagia, dysarthria, hemiparesis, visual changes? |
|
Definition
|
|
Term
| What is the preferred treatment of brain tumors? |
|
Definition
|
|
Term
| Cerebral edema and rapidly rising ICP are possible complications of radiation therapy. What can be used to manage these? |
|
Definition
| high dose corticosteroids |
|
|
Term
| What is a method of delivering highly concentrated doses of radiation precisely at the brain tumor? |
|
Definition
| stereotactic radiosurgery |
|
|
Term
| A group of chemotherapeutic drugs called what are used to treat brain tumors? |
|
Definition
| nitrosoureas (ex BCNU, CCNU) |
|
|
Term
| What is the first oral chemotherapeutic agent found to cross the blood brain barrier? |
|
Definition
|
|
Term
| What do you need to assess before giving Temodar? How should it be taken? |
|
Definition
-neutrophil and platelet count
-on an empty stomach |
|
|
Term
| What is an opening into the cranium with a drill, used to remove localized fluid and blood beneath the dura? |
|
Definition
|
|
Term
| For how long s/p cranial surgery are frequent neuro status checks essential? |
|
Definition
|
|
Term
| Why is Phenergan typically not used with neurologically impaired pts? |
|
Definition
| it increases somnolence thus impairing accurate neuro assessment |
|
|
Term
| If the pt with cranial surgery has an incision over the anterior or middle fossa, what angle does the HOB need to stay at? |
|
Definition
|
|
Term
| If the cranial surgery pt has a posterior fossa incision or a Burr hole where should the HOB remain? |
|
Definition
|
|
Term
| What is the major positioning rule for a pt with a craniectomy? What should the RN do if excessive bleeding or clear drainage is noticed from the site? |
|
Definition
-do not lay on the operative side
-immediately notify the surgeon |
|
|
Term
| Once the wound dressing is removed for the cranial surgery pt what should be used to clean the site? |
|
Definition
|
|
Term
| For the pt receiving cranial radiation, what recommendations are made if sun exposure is expected? |
|
Definition
| sunblock and head covering |
|
|
Term
| What is an accumulation of pus within the brain tissue from a local or systemic infection? |
|
Definition
|
|
Term
| What is the primary treatment of brain abscess? What is the secondary treatment if the primary fails? |
|
Definition
-primary antimicrobial therapy
-drainage or removal |
|
|
Term
| How does meningitis causative organisms usually gain entry into the body? |
|
Definition
| upper respiratory tract or bloodstream |
|
|
Term
| What type of living condition increases the risk for spread of bacterial meningitis? |
|
Definition
jail, college dorms, retirement homes
-anywhere that many people live in close proximity |
|
|
Term
| What are the 2 identifiable symptoms of meningitis? |
|
Definition
| photophobia and nuchal rigidity |
|
|
Term
| What are the general S&S of meningitis? |
|
Definition
| fever, severe HA, nausea, vomiting, nuchal rigidity, photophobia, decrease LOC, increased ICP |
|
|
Term
| Why can HAs from meningitis last for months after diagnosis? |
|
Definition
| that is the amount of time it takes the irritation and inflammation to completely resolve |
|
|
Term
| What tests should be done if meningitis is suspected? What is the definitive diagnostic test for meningitis? |
|
Definition
-CT scan and blood culture
-LP |
|
|
Term
| What are the 2 usual treatments for bacterial meningitis? |
|
Definition
| antibiotics and corticosteroids |
|
|
Term
| What is the best way to prevent bacterial meningitis? |
|
Definition
| prevention of respiratory infections by vaccinations |
|
|
Term
| Why is Codeine usually given for pain d/t bacterial meningitis? |
|
Definition
| relieves pain without sedation |
|
|
Term
| Why must fever be aggressively managed in the pt with bacterial meningitis? |
|
Definition
| fever increases cerebral edema and frequency of seizures |
|
|
Term
| How should fluid loss be calculated for the pt with bacterial meningitis? |
|
Definition
| 800 mL for insensible water loss and 100 mL for each degree over 100.4 F |
|
|
Term
| How soon following discharge for bacterial meningitis can normal activity be resumed? |
|
Definition
|
|
Term
| What is the diet teaching for pts discharged after bacterial meningitis? |
|
Definition
| high protein, high calorie in frequent small meals |
|
|
Term
| What can help relieve the muscle rigidity after discharge for bacterial meningitis? |
|
Definition
| progressive range of motion and warm bath |
|
|
Term
| How can encephalitis be prevented? |
|
Definition
| mosquito control by eliminating water sources and insect repellant |
|
|
Term
| What is used to treat encephalitis? |
|
Definition
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