(^234) Medical-Surgical Nursing Demystified
- Assist the patient with positioning for safety and comfort.
- Explain to the patient:
- Nature of disease.
- Genetic counseling available for family members of patients.
Meningitis
WHAT WENT WRONG?
Meningitis is the inflammation of the meningeal coverings of the brain and spinal
cord, most commonly due to bacteria or viral cause, although it can also be caused
by fungus, protozoa, or toxic exposure. Bacterial meningitis is the most common
and is typically due to Streptococcus pneumoniae(pneumococcal),Neisseria menin-
gitides(meningococcal), or Haemophilus influenzae. The incidence of H. influenzae
meningitis infections has decreased since the vaccine against H. influenzaebegan
to be used routinely in infants in the early 1990s. Other organisms that can cause
bacterial meningitis include Staphylococcus aureus,Escherichia coli, and Pseudo-
monas. Organisms typically travel either through the bloodstream to the central
nervous system or enter by direct contamination (skull fracture or extension from
sinus infections). Bacterial meningitis is more common in colder months when
upper respiratory tract infections are more common. People in close living con-
ditions, such as prisons, military barracks, or college dorms are at greater risk for
outbreaks of bacterial meningitis due to likelihood of transmission.
Viral meningitis may follow other viral infections, such as mumps, herpes sim-
plex or zoster, enterovirus, and measles. Viral meningitis is often a self-limiting
illness.
Patients who are immunocompromised have an increased risk for contracting a
fungal meningitis. This may travel from the bloodstream to the central nervous
system or by direct contamination. Cryptococcus neoformansmay be the causative
organism in these patients.PROGNOSIS
Identification of meningitis and the causative organism is important in order to
adequately treat the patient. Bacterial meningitis still has a significant mortality rate
and these patients need to be managed in the hospital. Some patients will have per-
manent neurologic effects following the acute episode. Viral meningitis is typically10