University:
Northwest College
Course:
VN420 | Child Health
Academic year:

2024
Views:

239

Pages:

3
Author:

Yesenia M.

BACTERIAL MENINGITIS- PEDS An infection of the meninges , the lining that surrounds the brain and spinal cord Serious illness → can lead to brain damage, nerve damage, deafness, strokes, & death One of the most common cause of meningitis in children → haemophilus influenzae type B ; has DECREASED in some developed countries thanks to HIB vaccine Pathophysiology Causes inflammation, swelling, purulent exudates, and tissue damage to the brain Can occur as a asecondary infection to URI’s, sinus infections, ear infections or through direct introduction through lumbar puncture, skull fx, severe head injury , neurosx intervention, or presence of foreign bodies Therapeutic management Medical emergency – requires immediate tx Rapid decline can occur in < 24 hrs→ leading to neuro damage/death IV ABX started immediately after LP and blood cultures Corticosteroids- to decrease imflammation Assessment Sudden onset of s/s Preceding RR illness Preceding sore throat Fever/chills HA Vomiting Photophobia Stiff neck Rash Irritable Drowsiness Lethargy Muscle rigidity Seizures RISK FACTORS: age 1-5, fever or illness during pregnancy or around delivery, exposure to ill people or people w TB, recent travel, recent neurosurgical procedure, presence of foreign body , immunocompromised status, close contact living spaces such as dormitories or military bases, day care attendance Physical examination Infant may rest in OPISTHOTONIC position- head & neck are hyperextended to relieve discomfort Bulging fontanels→ late sign * Positive Kernig & Brudzinski sign – can indicate irritation of the meninges Rash, petechial, vesicular or macular rash Lab and DX tests: LP , CBC, blood/urine/nasopharyngeal cultures Nursing management Give ABX Ensure proper ventilation, reduce imflammation, help prevent injury to the brain Interventions: reduce ICP and maintain cerebral perfusion along w tx fluid volume deficit, controlling seizures, and preventing injury that may result from ALOC or seizures Isolation precautions * → DROPLET AND STANDARD x24 hrs of ABX PREVENTING BACTERIAL MENINGITIS Postexposure ppx or postexposure immunization can be effective Disinfect toys and other shared objects to prevent transmission To reduce group b streptococcus infection in neonates- screen pregnant women ; if positive → given intrapartal ABX Hib vaccine is routine starting at 2mo and all children should be vaccinated to continue reduction of bacterial meningitis