NSG223 exam #4 (units 11-13)
Meningitis - answer- inflammation of the meninges
- septic: caused by bacteria (Neisseria meningitides, streptococcus pneumoniae), more
severe**
- aseptic: caused by virus secondary to cancer or weak immune system, less severe
3 layers of meninges - answer- dura mater
- arachnoid mater
- pia mater
(superficial to deep)
How is bacterial meningitis transmitted? - answer- kissing
- sharing utensils
- coughing
- sneezing
- respiratory droplets in throat or nasal passageways
symptoms of meningitis - answer- throbbing steady headache
- fever
- stiff neck (rigidity)
- altered mental status
- rash (bacterial sign)
- photophobia
- positive Kernig sign (bend knee and hip to 90 degrees, then extend knee - causes
pain)**
- positive Brudzinski sign (flexing chin to chest causes patient to raise legs also)**
diagnostic tests for meningitis - answer- H&P (living conditions, activity)
- CSF aspiration**
- Kernig sign (bend knee and hip to 90 degrees, then extend knee)
- Brudzinski sign (flex chin to chest, see if patient raises legs also)
- CT scan
treatment of meningitis - answer- meningococcal vaccine for prevention
- Dexamethasone (15-20 min before antibiotics)**
- IV antibiotics for bacterial only (Pen G w/ cephalosporin)**
- hydration
- seizure precautions
nursing management of meningitis - answer- droplet precautions
- fever management (Tylenol, cooling blankets)**
- frequent vital signs and LOC evaluation
, - daily weight
- hydration (I&O)
- prevent complications from immobility (SCDs)
glaucoma - answer- increased intraocular fluid
- increased intraocular pressure on optic nerve
- aqueous production and drainage not in balance
risk factors for glaucoma - answer- age older than 40
- cardiovascular disease
- hypertension
- previous eye trauma
- Prednisone use
- history of migraines
- family history of glaucoma
- diabetes
types of glaucoma - answer- open angle (wide): most common - fluid cannot pass
through trabecular meshwork
- narrow angle (angle closure): fluid stuck between lens and iris
symptoms of glaucoma - answer- peripheral vision loss
- blurred vision
- halos around lights
- "silent thief" (unaware of condition until significant loss)
- difficulty adjusting eyes to low light
diagnostics for glaucoma - answer- tonometry (measures intraocular pressure, 10-21
mmHg)
- slit-lamp exam (visualizes optic nerve)
- central visual field testing
treatment for glaucoma - answer- prevent further optic nerve damage
- control intraocular pressure
- Trimolol eyedrops (Betablocker) - decreases fluid production, use in AM**
- Pilocarpine eyedrops (cholinergic) - increases outflow by contracting pupil
- Brimonidine (alpha 2 agonist) - decreases fluid production
- trabeculectomy surgery
nursing management of glaucoma - answer- medication education (ability to use, only 1
drop at a time, lifelong therapy)
- patient needs to know intraocular pressure
cataracts symptoms - answer- cloudiness of the lens
- painless
- sensitivity to glare
Meningitis - answer- inflammation of the meninges
- septic: caused by bacteria (Neisseria meningitides, streptococcus pneumoniae), more
severe**
- aseptic: caused by virus secondary to cancer or weak immune system, less severe
3 layers of meninges - answer- dura mater
- arachnoid mater
- pia mater
(superficial to deep)
How is bacterial meningitis transmitted? - answer- kissing
- sharing utensils
- coughing
- sneezing
- respiratory droplets in throat or nasal passageways
symptoms of meningitis - answer- throbbing steady headache
- fever
- stiff neck (rigidity)
- altered mental status
- rash (bacterial sign)
- photophobia
- positive Kernig sign (bend knee and hip to 90 degrees, then extend knee - causes
pain)**
- positive Brudzinski sign (flexing chin to chest causes patient to raise legs also)**
diagnostic tests for meningitis - answer- H&P (living conditions, activity)
- CSF aspiration**
- Kernig sign (bend knee and hip to 90 degrees, then extend knee)
- Brudzinski sign (flex chin to chest, see if patient raises legs also)
- CT scan
treatment of meningitis - answer- meningococcal vaccine for prevention
- Dexamethasone (15-20 min before antibiotics)**
- IV antibiotics for bacterial only (Pen G w/ cephalosporin)**
- hydration
- seizure precautions
nursing management of meningitis - answer- droplet precautions
- fever management (Tylenol, cooling blankets)**
- frequent vital signs and LOC evaluation
, - daily weight
- hydration (I&O)
- prevent complications from immobility (SCDs)
glaucoma - answer- increased intraocular fluid
- increased intraocular pressure on optic nerve
- aqueous production and drainage not in balance
risk factors for glaucoma - answer- age older than 40
- cardiovascular disease
- hypertension
- previous eye trauma
- Prednisone use
- history of migraines
- family history of glaucoma
- diabetes
types of glaucoma - answer- open angle (wide): most common - fluid cannot pass
through trabecular meshwork
- narrow angle (angle closure): fluid stuck between lens and iris
symptoms of glaucoma - answer- peripheral vision loss
- blurred vision
- halos around lights
- "silent thief" (unaware of condition until significant loss)
- difficulty adjusting eyes to low light
diagnostics for glaucoma - answer- tonometry (measures intraocular pressure, 10-21
mmHg)
- slit-lamp exam (visualizes optic nerve)
- central visual field testing
treatment for glaucoma - answer- prevent further optic nerve damage
- control intraocular pressure
- Trimolol eyedrops (Betablocker) - decreases fluid production, use in AM**
- Pilocarpine eyedrops (cholinergic) - increases outflow by contracting pupil
- Brimonidine (alpha 2 agonist) - decreases fluid production
- trabeculectomy surgery
nursing management of glaucoma - answer- medication education (ability to use, only 1
drop at a time, lifelong therapy)
- patient needs to know intraocular pressure
cataracts symptoms - answer- cloudiness of the lens
- painless
- sensitivity to glare
