Rule Out the Diagnosis of Meningitis
please use my textbook ' Lehne's Pharmacology for Nursing Care E-Book
by Jacqueline Burchum; Laura Rosenthal for the medications''
and
use my MedSurg textbook "Lewis's Medical-Surgical Nursing E-Book
Assessment and Management of Clinical Problems, Single Volume
by Mariann M. Harding; Jeffrey Kwong; Dottie Roberts; Debra Hagler; Courtney Reinisch"
A college student comes to the student health department and complains of a “bad” headache and sore neck. He wants to have some pain medication and wants to know if he can have a referral for a chiropractor so he can return to basketball practice. The nurse checks his vital signs which are T 101 degrees F, BP 84/52, HR 124, RR 24. When the nurse uses a penlight to check the patient’s pupils, the patient complains of discomfort from the light shining in his eyes.
The nurse suspects the patient has meningitis. The nurse is going to complete the following assessments.
Please explain each one and why it is used.
Neurological assessment including the Glasgow Coma Scale and check of the cranial nerves
Brudzinski and Kernig’s signs
Inspecting the skin for a skin rash and petechiae
The nurse quickly assesses risk factors for meningitis—what are the risk factors—which of these does the nurse suspect in this patient?
The nurse will prepare the patient for what test to diagnose meningitis?
What other diagnostic tests would be used to confirm or rule out the diagnosis of meningitis?
What samples are essential to obtain before antibiotics are started?
What kind of isolation might be ordered for this patient?
The following medications have been ordered while the physician waits for the results of the cultures.
Explain why each is used and how the nurse should monitor the patient receiving them.
Ceftazidime IV
Hydrocodone as needed for pain
Dexamethasone IV daily
Acetaminophen as needed for fever above 100.4 degrees F
Phenytoin IV
Lorazepam prn
Neurological assessments are fundamental for confirming or ruling out the presence of meningeal inflammations. Nurses use the Glasgow Coma Scale as a strong predictor of how the patient reacts to the disease. They also conduct other physical assessments like Brudzinski, which involves positioning the patient with hips flexed at a certain angle. The technique informs the presence or absence of the disease. Similarly, Kernig’s signs try to straighten the leg with a flexed hip to 90 degrees to alert about meningitis symptoms (Harding et al., 2019). Finally, inspecting skin rash and petechiae represent typical skin symptoms for confirming meningitis in a patient.
Meningitis risk factors include skipped vaccinations, poor immunity, pregnancy, settings, and age. In the context of the student, the nurse would suspect community living, such as dormitories, as the primary suspect. As a result, the nurse will prepare the patient for CSF analysis, culture, Gram stain, CBC, and blood culture tests (Harding et al., 2019). Other tests may include skull x-rays, MRI, and CT scans (Harding et al., 2019...
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