p.6
Bacterial Meningitis: Causes and Symptoms
What are the common causes of meningitis?
Bacteria, virus, or fungus.
p.23
Prevention and Treatment of Bacterial Meningitis
What is a crucial step in managing increased intracranial pressure (ICP) in meningitis and encephalitis patients?
Reduction of increased ICP.
p.9
Bacterial Meningitis: Causes and Symptoms
What are common causative agents of bacterial meningitis in children under 2 months old?
Group B streptococcus, Haemophilus influenzae Type B, Escherichia coli.
p.8
Bacterial Meningitis: Causes and Symptoms
Why is bacterial meningitis considered a medical emergency?
Because it develops rapidly and can be life-threatening.
p.5
Types of Neurological Infections
What are the common causes of meningitis?
Bacteria, viruses, and fungi.
p.1
Anatomy and Physiology of Pediatric Differences
How is the head size of a pediatric patient different in proportion to the body?
The head size is large in proportion to the body.
p.25
Nursing Management for Meningitis and Encephalitis
What nursing diagnosis addresses the risk of dehydration due to poor oral fluid intake?
Risk of fluid volume deficit.
p.30
Lumbar Puncture: Indications and Risks
Why is increased intracranial pressure (ICP) a contraindication for lumbar puncture?
Increased ICP can lead to brain herniation during a lumbar puncture.
p.30
Lumbar Puncture: Indications and Risks
Why is hypotension a contraindication for lumbar puncture?
Hypotension can complicate the procedure and increase the risk of adverse effects.
p.30
Lumbar Puncture: Indications and Risks
What spinal conditions are contraindications for lumbar puncture?
Spinal hematoma and abscess.
p.21
Prevention and Treatment of Bacterial Meningitis
What is a key method to prevent the condition mentioned?
Prevent the spread of viral infections.
p.8
Bacterial Meningitis: Causes and Symptoms
How is bacterial meningitis transmitted?
Through person-to-person contact via droplets of respiratory or throat secretions from carriers.
p.31
Lumbar Puncture: Indications and Risks
How can the frequency of headaches be reduced after a lumbar puncture?
By having the patient remain lying flat for 1-4 hours after the procedure.
p.30
Lumbar Puncture: Indications and Risks
What is a contraindication for lumbar puncture related to blood clotting?
Coagulopathy: active bleeding with a low platelet count.
p.29
Lumbar Puncture: Indications and Risks
What are the indications for a lumbar puncture in a child?
Fever of unknown origin, suspected CNS infection, altered mental status, positive blood culture, suspected subarachnoid haemorrhage, seizures of unknown aetiology.
p.5
Types of Neurological Infections
What type of infection is encephalitis?
A neurological infection.
p.23
Prevention and Treatment of Bacterial Meningitis
Why is ventilation important in the treatment of meningitis and encephalitis?
To ensure adequate oxygenation and prevent respiratory complications.
p.24
Nursing Management for Meningitis and Encephalitis
What factors determine the prognosis of an infection in a child?
Age of the child, types of organism, severity of the infection, duration of the illness, and sensitivity of the organism to antimicrobial drugs.
p.30
Lumbar Puncture: Indications and Risks
Why is status epilepticus or uncontrolled seizure activity a contraindication for lumbar puncture?
Uncontrolled seizure activity can make the procedure unsafe and increase the risk of complications.
p.21
Prevention and Treatment of Bacterial Meningitis
Is there a vaccination available for the prevention of the condition mentioned?
No, up to now, no vaccination is available.
p.5
Types of Neurological Infections
What are the main types of neurological infections?
Meningitis and Encephalitis.
p.23
Prevention and Treatment of Bacterial Meningitis
How is temperature control relevant in the treatment of meningitis and encephalitis?
Control of extremes of temperature is necessary to prevent further complications.
p.25
Nursing Management for Meningitis and Encephalitis
What nursing diagnosis is related to airway issues due to altered consciousness?
Ineffective airway clearance.
p.23
Prevention and Treatment of Bacterial Meningitis
Why is seizure control important in the treatment of meningitis and encephalitis?
To prevent further neurological damage and complications.
p.1
Anatomy and Physiology of Pediatric Differences
Is myelination complete at birth?
No, myelination is incomplete at birth.
p.17
Clinical Manifestations of Meningitis
What are some acute onset symptoms of febrile neurological infections?
Acute onset of febrile, presence of neurologic signs such as altered reflexes, disorientation, confusion.
p.15
Clinical Manifestations of Meningitis
What is a tense anterior fontanel a sign of in infants?
It is a sign of meningeal irritation in clinical manifestations similar to bacterial meningitis.
p.28
Lumbar Puncture: Indications and Risks
What is another purpose of performing a lumbar puncture?
To administer medications in the intrathecal space.
p.14
Types of Neurological Infections
Which age group is at higher risk for viral meningitis?
Infants older than 1 month.
p.16
Types of Neurological Infections
How can mosquitoes contribute to the transmission of encephalitis?
Mosquitoes can transmit viruses for several types of encephalitis, including Japanese encephalitis and West Nile encephalitis.
p.6
Clinical Manifestations of Meningitis
What is meningitis?
Acute inflammation of the meninges and the central nervous system (CNS).
p.25
Nursing Management for Meningitis and Encephalitis
What nursing diagnosis is related to a decreased level of consciousness affecting breathing?
Inability to sustain spontaneous ventilation.
p.1
Anatomy and Physiology of Pediatric Differences
What is the brain weight of a newborn compared to an adult?
At birth, the brain weight is 2/3 of an adult brain.
p.24
Nursing Management for Meningitis and Encephalitis
Why is the type of organism important in determining the prognosis of an infection?
Different organisms can cause varying levels of severity and respond differently to treatments.
p.23
Prevention and Treatment of Bacterial Meningitis
What should be addressed in addition to the primary treatment of meningitis and encephalitis?
Treatment of complications that may arise during the course of the illness.
p.15
Clinical Manifestations of Meningitis
What are the general symptoms of clinical manifestations similar to bacterial meningitis?
Irritable or lethargic, fever, general malaise, gastrointestinal distress (e.g., abdominal pain, diarrhea), upper respiratory syndromes, maculopapular rash, meningeal irritation, headache, photophobia, stiff neck, neck pain, and positive Kernig & Brudzinski signs.
p.17
Clinical Manifestations of Meningitis
What are some common clinical manifestations of neurological infections?
Speech disturbance, motor dysfunction, signs of an upper respiratory infection, nausea & vomiting, seizures, respiratory failure, increased cerebrospinal pressure.
p.30
Lumbar Puncture: Indications and Risks
Why is a superficial infection at or near the lumbar puncture site a contraindication?
A superficial infection can spread to deeper tissues during the procedure.
p.20
Prevention and Treatment of Bacterial Meningitis
What is a key method for preventing bacterial meningitis?
Meningococcal vaccination.
p.16
Types of Neurological Infections
Which groups are most commonly affected by encephalitis?
Children, elderly, and immunocompromised patients.
p.11
Clinical Manifestations of Meningitis
What are the CNS-related symptoms of meningitis in young infants?
Alert but less active, or difficult to wake/sleepy & lethargic, bulging anterior fontanel, and irritability.
p.14
Types of Neurological Infections
How are other viruses that cause viral meningitis transmitted?
Through direct or indirect contact with saliva or sputum of an infected person.
p.4
Glasgow Coma Scale for Infants and Young Children
What motor response corresponds to a score of 2 in the Glasgow Coma Scale for infants and young children?
Abnormal extension (decerebrate).
p.2
Anatomy and Physiology of Pediatric Differences
At what rate is cerebrospinal fluid produced in infants compared to adults?
100 ml/day in infants compared to 500 ml/day in adults.
p.26
Nursing Management for Meningitis and Encephalitis
What type of environment should be provided for a patient with meningitis?
A quiet environment to reduce stimulation and activity.
p.6
Clinical Manifestations of Meningitis
Which other infections may be associated with meningitis?
Otitis media, sinusitis, pharyngitis, or pneumonia.
p.9
Bacterial Meningitis: Causes and Symptoms
Which bacteria commonly cause bacterial meningitis in children over 2 months old?
Haemophilus influenzae Type B, Neisseria meningitides (Meningococcal meningitis), Streptococcus pneumonia (Pneumococcal meningitis).
p.30
Lumbar Puncture: Indications and Risks
How does a lumbar skin infection affect the safety of a lumbar puncture?
A lumbar skin infection can introduce pathogens into the spinal canal during the procedure.
p.13
Clinical Manifestations of Meningitis
What mental status changes might be observed in a patient with meningitis?
Altered mental status, which can include confusion, lethargy, or difficulty waking up.
p.14
Types of Neurological Infections
Which viral infections can lead to secondary viral meningitis?
Mumps, Measles, or Influenza.
p.11
Clinical Manifestations of Meningitis
What are common clinical manifestations of meningitis in young infants?
Fever, alert but less active or difficult to wake/sleepy & lethargic, bulging anterior fontanel, pale and blotchy skin, irritability, refusal to eat, vomiting, diarrhea, and haemorrhagic rash.
p.11
Clinical Manifestations of Meningitis
What are the CNS-related symptoms of meningitis in older children?
Severe headache, irritability, lethargy, confusion, and meningeal irritation.
p.4
Glasgow Coma Scale for Infants and Young Children
What is the highest score for motor response in the Glasgow Coma Scale for infants and young children?
6, indicating spontaneous movement.
p.2
Anatomy and Physiology of Pediatric Differences
What is a characteristic of the pediatric brain in terms of vascularity and the subarachnoid space?
The pediatric brain is highly vascular, and the subarachnoid space is small.
p.2
Anatomy and Physiology of Pediatric Differences
When does the anterior fontanel close in infants?
Between 12 to 18 months of age.
p.26
Nursing Management for Meningitis and Encephalitis
What vital signs and observations are important in nursing management of meningitis?
Monitoring vital signs and observing neurologic signs.
p.10
Clinical Manifestations of Meningitis
What factors influence the clinical manifestations of meningitis?
Age of the child, pathogen, and length of illness before diagnosis.
p.23
Prevention and Treatment of Bacterial Meningitis
What is one of the key aspects of treating meningitis and encephalitis?
Maintenance of optimal hydration.
p.24
Nursing Management for Meningitis and Encephalitis
How does the age of a child affect the prognosis of an infection?
The prognosis can vary depending on the child's age, with younger children often being more vulnerable.
p.24
Nursing Management for Meningitis and Encephalitis
How does the severity of the infection influence the prognosis?
More severe infections generally have a worse prognosis and may require more intensive treatment.
p.24
Nursing Management for Meningitis and Encephalitis
Why is the duration of the illness a factor in determining prognosis?
Longer durations of illness can lead to more complications and a worse prognosis.
p.24
Nursing Management for Meningitis and Encephalitis
How does the sensitivity of the organism to antimicrobial drugs affect the prognosis?
Organisms that are sensitive to antimicrobial drugs are easier to treat, leading to a better prognosis.
p.27
Nursing Management for Meningitis and Encephalitis
What should be monitored in a child undergoing treatment for meningitis and encephalitis?
The child’s response to treatment and medications.
p.27
Nursing Management for Meningitis and Encephalitis
How can parents be involved in the care of a child with meningitis and encephalitis?
Encourage parents to participate in care.
p.20
Prevention and Treatment of Bacterial Meningitis
What is the recommended dosing scheme for Prevenar 13 in Hong Kong from 2019?
Two primary doses followed by a booster dose around 1 year of age.
p.18
Diagnosis of Meningitis and Encephalitis
What changes in blood cell count are typically seen in meningitis?
Increased white blood cell (WBC) count.
p.16
Types of Neurological Infections
What is the usual cause of encephalitis?
Encephalitis is usually caused by a virus.
p.11
Clinical Manifestations of Meningitis
What gastrointestinal symptoms are associated with meningitis in young infants?
Refusal to eat, vomiting, and diarrhea.
p.19
Diagnosis of Meningitis and Encephalitis
What is the role of serologic diagnosis in diagnosing meningitis and encephalitis?
It involves testing blood serum for antibodies or antigens to identify infections.
p.10
Clinical Manifestations of Meningitis
How quickly can symptoms of meningitis appear?
Symptoms may have a sudden onset or develop over about 1 week.
p.5
Types of Neurological Infections
Which organisms can cause meningitis?
Bacteria, viruses, and fungi.
p.23
Prevention and Treatment of Bacterial Meningitis
What is a critical aspect of managing bacterial shock in meningitis and encephalitis patients?
Management of bacterial shock to stabilize the patient's condition.
p.9
Bacterial Meningitis: Causes and Symptoms
Which bacterium is a common cause of bacterial meningitis in both children under and over 2 months old?
Haemophilus influenzae Type B.
p.7
Clinical Manifestations of Meningitis
How does the infection extend within the brain?
The infection extends to the ventricles.
p.22
Prevention and Treatment of Bacterial Meningitis
What is the typical duration for administering antibiotics intravenously for bacterial meningitis?
7 to 21 days, depending on the causative organism.
p.17
Clinical Manifestations of Meningitis
What changes in personality and behavior might indicate a neurological infection?
Changes in personality and behavior, severe headache, meningeal signs.
p.27
Nursing Management for Meningitis and Encephalitis
What can parents bring to help comfort a child in the hospital?
Some favorite toys or music.
p.12
Clinical Manifestations of Meningitis
What are common clinical manifestations of meningeal irritation?
Headache, photophobia, nuchal rigidity, opisthotonic position, positive Kernig or Brudzinski sign or both.
p.16
Types of Neurological Infections
How common is encephalitis?
Encephalitis occurs in approximately 0.5 per 100,000 individuals.
p.12
Clinical Manifestations of Meningitis
What is a positive Kernig sign?
With the hip and knee flexed at 90º, the knee cannot be extended more than 135º and/or there is flexion of the opposite knee.
p.4
Glasgow Coma Scale for Infants and Young Children
What motor response corresponds to a score of 2 in the Glasgow Coma Scale for older children and adults?
Extension to pain (decerebrate).
p.26
Nursing Management for Meningitis and Encephalitis
Why should a patient with meningitis be isolated?
To prevent possible infection.
p.25
Nursing Management for Meningitis and Encephalitis
What nursing diagnosis addresses the risk of temperature regulation issues due to infection?
Risk of ineffective thermoregulation.
p.7
Types of Neurological Infections
How can an organism spread into the cerebrospinal fluid (CSF)?
Through direct implantation, such as skull fracture, lumbar puncture, or anatomic abnormalities.
p.7
Clinical Manifestations of Meningitis
What is the initial response of the body to an infectious process in the brain?
Inflammation, which produces exudate and white blood cells, leading to tissue damage.
p.1
Anatomy and Physiology of Pediatric Differences
Is the blood-brain barrier fully developed at birth?
No, the blood-brain barrier is not fully developed at birth.
p.9
Bacterial Meningitis: Causes and Symptoms
What type of meningitis is caused by Neisseria meningitides?
Meningococcal meningitis.
p.1
Anatomy and Physiology of Pediatric Differences
What type of motor reflexes are present in newborns?
Primitive motor reflexes.
p.7
Clinical Manifestations of Meningitis
What can thick pus, fibrin, or adhesions cause in the brain?
They may occlude the narrow passage and obstruct the flow of cerebrospinal fluid (CSF).
p.22
Prevention and Treatment of Bacterial Meningitis
Name some antibiotics used in the treatment of bacterial meningitis.
Ampicillin, Aminoglycoside, Cephalosporin (cefotaxime), Ciprofloxacin.
p.27
Nursing Management for Meningitis and Encephalitis
What should be done to help a child adjust to the hospital environment?
Reorient the child to the hospital environment.
p.20
Prevention and Treatment of Bacterial Meningitis
How many types of meningococcal vaccines are available in Hong Kong?
Three: 1 bivalent (serogroups A & C) and 2 quadrivalent (serogroups A, C, Y & W135).
p.18
Diagnosis of Meningitis and Encephalitis
What are the key components of diagnosing meningitis and encephalitis?
History, clinical presentations, laboratory investigation, and lumbar puncture.
p.12
Clinical Manifestations of Meningitis
What is the opisthotonic position?
A position where the body is held in an arching posture.
p.14
Types of Neurological Infections
How are enteroviruses that cause viral meningitis transmitted?
Through the faecal-oral route and respiratory secretions.
p.16
Types of Neurological Infections
Name some viruses that can cause encephalitis.
Enterovirus, Influenza A, Poliovirus.
p.19
Diagnosis of Meningitis and Encephalitis
What is the purpose of a blood culture in the diagnosis of meningitis and encephalitis?
To detect the presence of bacteria or other pathogens in the blood.
p.26
Nursing Management for Meningitis and Encephalitis
What is the recommended positioning for a patient with meningitis to promote comfort?
The head of the bed should be slightly elevated with no pillow.
p.7
Clinical Manifestations of Meningitis
What happens to the brain during an infectious process?
The brain becomes hyperemic and edematous, and the entire surface is covered with a layer of purulent exudates.
p.15
Clinical Manifestations of Meningitis
What gastrointestinal symptoms can be observed in clinical manifestations similar to bacterial meningitis?
Abdominal pain and diarrhea.
p.15
Clinical Manifestations of Meningitis
How long do symptoms of clinical manifestations similar to bacterial meningitis usually last?
Symptoms usually resolve spontaneously within 7 - 10 days.
p.17
Clinical Manifestations of Meningitis
What are meningeal signs?
Signs indicating irritation of the meninges, such as severe headache and neck stiffness.
p.11
Clinical Manifestations of Meningitis
What are common clinical manifestations of meningitis in older children?
High fever, severe headache, irritability, lethargy, confusion, meningeal irritation, refusal to eat, nausea and vomiting, and haemorrhagic rash.
p.11
Clinical Manifestations of Meningitis
What are some severe complications that meningitis may progress to?
Seizure, apnea, cerebral edema, subdural effusion, hydrocephalus, disseminated intravascular coagulation (DIC), shock, increased intracranial pressure, and septic arthritis.
p.2
Anatomy and Physiology of Pediatric Differences
How are the cranial bones and sutures different in pediatric patients?
Pediatric patients have thin cranial bones that are not well developed and unfused sutures.
p.19
Diagnosis of Meningitis and Encephalitis
What does EEG stand for and what is its role in diagnosing meningitis and encephalitis?
Electroencephalogram; it measures electrical activity in the brain.
p.25
Nursing Management for Meningitis and Encephalitis
What nursing diagnosis addresses social issues due to decreased consciousness and isolation?
Impaired social interaction.
p.13
Clinical Manifestations of Meningitis
What are common clinical manifestations of meningitis?
Fever, headache, stiff neck, sensitivity to light, nausea, vomiting, and altered mental status.
p.30
Lumbar Puncture: Indications and Risks
How does gestational age affect the risks associated with lumbar puncture?
Risks increase with lower gestational ages.
p.22
Prevention and Treatment of Bacterial Meningitis
What antiviral medication might be used for viral meningitis?
Acyclovir or other antiviral agents.
p.28
Lumbar Puncture: Indications and Risks
What is a lumbar puncture (LP)?
The insertion of a needle into the spinal canal to drain a small amount of cerebrospinal fluid (CSF).
p.18
Diagnosis of Meningitis and Encephalitis
Which test is considered the most specific and sensitive for enterovirus infection in the context of meningitis?
PCR (Polymerase Chain Reaction).
p.15
Clinical Manifestations of Meningitis
What are the signs of meningeal irritation in clinical manifestations similar to bacterial meningitis?
Headache, photophobia, stiff neck, neck pain, and positive Kernig & Brudzinski signs.
p.17
Clinical Manifestations of Meningitis
What are some neurological signs that may present with a febrile illness?
Altered reflexes, disorientation, confusion.
p.28
Lumbar Puncture: Indications and Risks
What is one of the primary aims of a lumbar puncture?
To withdraw cerebrospinal fluid (CSF) for appropriate laboratory examinations.
p.18
Lumbar Puncture: Indications and Risks
What laboratory tests are commonly performed during a lumbar puncture for diagnosing meningitis?
Culture & gram stain, blood cell count, glucose and protein content, and PCR.
p.16
Types of Neurological Infections
What is encephalitis?
Encephalitis is an inflammation of the brain tissue.
p.18
Diagnosis of Meningitis and Encephalitis
What are the typical findings in glucose and protein content in cerebrospinal fluid (CSF) during meningitis?
Decreased glucose and increased protein content.
p.12
Clinical Manifestations of Meningitis
What is a positive Brudzinski sign?
Involuntary lifting of the legs when lifting a patient's head.
p.4
Glasgow Coma Scale for Infants and Young Children
What motor response corresponds to a score of 3 in the Glasgow Coma Scale for older children and adults?
Flexion to pain (decorticate).
p.2
Anatomy and Physiology of Pediatric Differences
How developed are the neck muscles in pediatric patients?
Neck muscles are not well developed.
p.19
Diagnosis of Meningitis and Encephalitis
What does CXR stand for and why is it used in diagnosing meningitis and encephalitis?
Chest X-Ray; it helps identify any respiratory infections that may be associated.
p.26
Nursing Management for Meningitis and Encephalitis
What actions should be avoided in the care of a child with meningitis?
Actions such as lifting the child's head should be avoided.
p.14
Types of Neurological Infections
What is the primary cause of viral (aseptic) meningitis?
Enteroviruses, accounting for 80 to 92% of all cases.
p.28
Lumbar Puncture: Indications and Risks
What can be measured during a lumbar puncture?
The pressure in the cerebrospinal fluid (CSF).
p.14
Types of Neurological Infections
Which children are at higher risk for viral meningitis?
Children with a weak immune system.
p.11
Clinical Manifestations of Meningitis
What gastrointestinal symptoms are associated with meningitis in older children?
Refusal to eat, nausea, and vomiting.
p.4
Glasgow Coma Scale for Infants and Young Children
What motor response corresponds to a score of 3 in the Glasgow Coma Scale for infants and young children?
Abnormal flexion (decorticate).
p.2
Anatomy and Physiology of Pediatric Differences
What is a characteristic of spinal mobility and the cervical spine in pediatric patients?
Pediatric patients have excessive spinal mobility, and the muscles, joint capsules, and ligaments of the cervical spine are immature.
p.19
Diagnosis of Meningitis and Encephalitis
What are the common laboratory investigations for diagnosing meningitis and encephalitis?
CBC, serologic diagnosis, blood culture, CXR, nose & throat cultures, UA & urine culture, EEG, CT/MRI.
p.19
Diagnosis of Meningitis and Encephalitis
What does UA stand for and what is its role in diagnosing meningitis and encephalitis?
Urinalysis; it helps detect abnormalities in the urine.
p.26
Nursing Management for Meningitis and Encephalitis
Why is it important to measure head circumference in infants with meningitis?
To monitor for signs of increased intracranial pressure.
p.26
Nursing Management for Meningitis and Encephalitis
How should care be organized for a patient with meningitis?
Care should be organized and prioritized.
p.26
Nursing Management for Meningitis and Encephalitis
Why should the side rails be lifted for a patient with meningitis?
To ensure the patient's safety.
