Lecture Notes on Meningitis

Introduction

• Presenter: Cathy, Level Up RN
• Focus: Key facts about meningitis
• Includes a quiz at the end

Meningitis Overview

• Definition: Inflammation of the meninges (membranes protecting the brain and spinal cord)
• Pathophysiology:
  • Infectious organism (bacteria or virus) enters CNS and meninges
  • Entry through bloodstream or direct trauma
  • Viral meningitis: Usually resolves without treatment
  • Bacterial meningitis: More severe, requires antibiotics, can be life-threatening

Risk Factors

• Crowded conditions (e.g., dorms, prisons)
• Immunosuppression
• Travel exposure

Prevention

• Vaccinations:
  • Infants: Hib and PCV vaccines
  • Teenagers: Meningitis vaccine (before college/dorm life)
• Example: Personal story about ensuring son received meningitis A and B vaccines before college

Signs and Symptoms

• Fever, headache, nausea, vomiting
• Nuchal rigidity: Neck stiffness
• Photophobia: Sensitivity to light
• Positive Brudzinski sign:
  • Test: Patient lies on back, head pulled up causes knees and hips to flex
  • Memory aid: "Bru, that hurts"
• Positive Kernig sign:
  • Test: Patient lies flat, knee bent and attempt to straighten leg causes pain
  • Memory aid: "K" for Kernig and Knee
• Altered mental status, tachycardia, seizures

Diagnosis

• Lumbar puncture to obtain cerebral spinal fluid (CSF)
• CSF analysis:
  • Bacterial meningitis:
    • Cloudy CSF
    • Decreased glucose, increased protein, increased WBCs
    • Positive Gram stain
  • Viral meningitis:
    • Clear CSF
    • Normal glucose, slight increase in protein and WBCs
    • Negative Gram stain

Treatment

• Antibiotics for bacterial meningitis
• Analgesics for pain relief
• Anticonvulsants if seizures are a concern

Nursing Care

• Droplet precautions for suspected/confirmed bacterial meningitis (first 24 hours with antibiotics)
  • Memory tip: Song "It's Raining Men" to remember droplet precautions
• Seizure precautions:
  • Pad side rails
  • Ensure oxygen equipment is available
• Monitor neurological status
• Provide a quiet room with dim lights (due to photophobia)
• Minimize intracranial pressure:
  • Head of the bed at 30 degrees
  • Keep head midline
  • Minimize suctioning

Quiz

• Question 1: Difference in CSF appearance between bacterial and viral meningitis?
  • Answer: Cloudy for bacterial, clear for viral.
• Question 2: Positive Kernig and Brudzinski signs in meningitis, true or false?
  • Answer: True
• Question 3: Precautions for suspected bacterial meningitis?
  • Answer: Droplet precautions

End of video notes. Be sure to review the notes and good luck with your studies!