Meningitis Practice Questions with Answers and NCLEX® Review

Introduction to Meningitis Nursing Interventions

Meningitis is a bacterial infection of the membranes around the brain and spinal cord, and can be caused by several different bacteria. 

There are three categories of meningitis: viral, bacterial, and fungal. Viral meningitis is usually more mild than bacterial or fungal meningitis, but still requires treatment with antiviral medications to prevent complications like hearing loss or long-term brain damage.

The most common bacteria that cause meningitis are Haemophilus influenzae type B (Hib) and Streptococcus pneumoniae (pneumococcus).

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Some types of meningitis can resolve without treatment, while others can be life-threatening. Bacterial meningitis should be promptly treated with antibiotics to avoid death.

Meningitis Pathophysiology

The word “meningitis” means swelling of the meninges, which are the membranes that cover the brain and spinal cord. The swelling may be due to several external or internal factors, including inflammation caused by an infection, a virus, or even a fungus. The types of meningitis depend on the underlying factors.

Meningitis is the inflammation of the Meninges (the inner lining of the brain & spinal cord).

The meninges act as a protective coating that reduces friction for the entire central nervous system, which is composed of the brain and spinal cord. Meningitis occurs when there is an infection in the meninges.

Pre-existing conditions like mumps, measles, or herpes cause viral meningitis. Viral meningitis is not contagious and is a preferred diagnosis to bacterial meningitis.

Bacterial meningitis is the more lethal version of meningitis since it can spread to the brain, and will result in death. But unlike viral meningitis, bacterial meningitis can be passed on to other people with a single cough or sneeze. If untreated, bacterial meningitis could cause brain damage in the client.

Bacterial meningitis begins when bacteria from the throat, ears, or sinuses invade the bloodstream. Once the bacteria reach the bloodstream, it can easily spread to other body parts, including the brain.

Causes of Meningitis

Meningitis is a serious infection of the brain and spinal cord. It’s caused by bacteria or viruses that enter your bloodstream and make their way to your central nervous system. The most common causes are bacteria, including viruses such as herpes simplex, or even fungus. Each type of meningitis has its own set of symptoms.

Bacterial meningitis can be caused by several different types of bacteria: Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae type B (Hib), Neisseria meningitidis (meningococcus), Listeria monocytogenes, and Mycoplasma pneumoniae. 

Viral meningitis is usually caused by herpes simplex virus type 1 or 2 (HSV-1 or HSV-2). 

Fungal meningitis is less common than bacterial or viral forms but is still very dangerous. It’s caused by rare fungi like Cryptococcus neoformans and Histoplasma capsulatum.

Memory Trick

• Bacterial = Bad news MOST contagious
• Viral = Very common – MOST tested

Signs and Symptoms

• Pediatrics
• High-pitched cry
• Bulging fontanelle
• Adults
• Agitation and altered LOC (1st sign)
• Leads to seizures, coma, and death

Memory Trick

• Headache and photophobia
• Hard stiff neck – nuchal rigidity
• High temp – fever

Tests

• • CT scan (done first)
  •  • LP (Lumbar Puncture “spinal tap”)
    •  – Viral – Very clear
    •  – Bacterial – Bad cloudy
    •  – Both types will have elevated WBCs
    •  – AFTER LP: Monitor insertion site dressing for clear fluid

Meningitis Nursing Interventions

The first nursing action would be to place the client on droplet precautions. And don’t forget PPE.

Assess the client’s level of consciousness and orientation to person, place, and time.

Assist clients with therapeutic maneuvers such as coughing, deep breathing, and postural drainage.

Administer antibiotics and intravenous fluids to reduce swelling and prevent dehydration.

Monitor for changes in mental status and signs of complications such as seizures, severe headaches, or confusion.

Meningitis Conclusion

Meningitis is an infection of the brain’s protective membranes. There are three types of meningitis: viral, bacterial, and fungal. Viral meningitis is usually milder than bacterial or fungal meningitis, but still requires treatment with antiviral medications to prevent complications like hearing loss or long-term brain damage.

When meningitis isn’t treated quickly and properly, death will occur. Clients with bacterial meningitis will need antibiotics right away.

Sources

https://www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508 

https://u.osu.edu/meningitiscasestudy/pathophysiology/