Inflammatory Conditions of the Brain

Inflammatory Conditions of the Brain

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Inflammatory Conditions of the Brain by Mind Map: Inflammatory Conditions of the Brain

1. Brain Abscess

1.1. Clinical manifestations: Headache, fever, N/V Temporal lobe abscess: visual field defects, psycho motor seizures Occipital abscess: visual impairment & hallucinations

1.2. Complications Increased ICP: drowsiness, confusion, seizures

1.3. Diagnostic studies CT scan & MRI

1.4. Collaborative care Antimicrobial therapy (primary tx), incision & drainage, supportive care

1.5. Health promotion Return to maximal neurologic functioning, manage symptoms, control pain & discomfort

1.6. Potential Nursing Diagnosis Acute Pain Anxiety

2. Encephalitis

2.1. Clinical manifestations: Fever headache, & N/V; signs appear on day 2 or 3 & vary from minimal alterations in mental status to coma

2.2. Complications Cytomegalovirus encephalitis (common w/ AIDS)

2.3. Diagnostic studies CT scan, EEG MRI, PET, PCR, IgM antibodies to virus in serum or CSF, blood test to detect viral RNA

2.4. Collaborative care Symptomatic & supportive care, prevention of increased ICP, acyclovir (Zovirax) & vidarabine (Vira-A) for HSV, antiseizure drugs

2.5. Health promotion Mosquito control (cleaning rain gutters, removing old tires, draining bird baths, & removing water where mosquitos breed), insect repellent

2.6. Potential Nursing Diagnosis Ineffective Tissue Perfusion Disturbed Sensory Perception

3. Bacterial Meningitis

3.1. Clinical manifestations: Headache, fever, N/V, nuchal rigidity (neck stiffness): photophobia, decreased LOC, signs of ICP, coma, seizures, headache worsens w/ vomiting & irritability Meningococcus -> skin rash (common), petechiae (trunk, lower extremities, mucous membranes)

3.2. Complications Increased ICP (altered mental status), residual neurologic dysfunction -> papilledema, ptosis, unequal pupils & diplopia, sensory loss, loss of corneal reflex, facial paresis, tinnitus, vertigo, deafness, hearing loss, hemiparesis, dysphasia, hemianopsia, cerebral abscess, subdural empyema, subdural effusion, or persistent meningitis, seizures, CN III palsy, bradycardia, hypertensive coma, & death, continuing headaches, noncommunicating hydrocephalus, Waterhouse-Friderichsen syndrome (petechiae, disseminate intravascular coagulation/ DIC, adrenal hemorrhage, & circulatory collapse); DIC & shock

3.2.1. Collaborative care Pain management for chronic headaches, surgical implantation of shunt (hydrocephalus), H & P (crucial), antibiotic therapy after collecting specimens Management Rest IV fluids Hypothermia Drug Therapy IV antibiotics ampicillin, penicillin cephalosporin (e.g., cefotaxime [Claforan], ceftriaxone [Rocephin]) codeine for headache dexamethasone (corticosteroid) acetaminophen or aspirin for temperature > 100.4*F (38* C) phenytoin IV mannitol (Osmitrol) IV for diuresis Collaborate w/ HCP to manage headache, fever, & nuchal rigidity Nursing Assessment: vital signs, neurologic assessment, fluid intake & output, evaluation of lungs & skin

3.2.2. Health promotion Prevent respiratory tract infections through vaccination (pneumococcal pneumonia & influenza – important) Meningococcal vaccines (US)  Meningococcal conjugate vaccines (MCV4) (Menactra, MenHibrix, Menveo)  Meningococcal polysaccharide vaccine (MPSV4) (Menomune)  Serogroup B meningococcal vaccines (Bexsero and Trumenba) Early & vigorous treatment of respiratory tract, & ear infection (important

3.2.3. Potential Nursing Diagnosis Infection Deficient Knowledge

3.3. Diagnostic studies Meningococcus- Tumbler test, blood culture, CT scan, lumbar puncture w/ CSF analysis (protein, WBC, & glucose), specimens of CSF, sputum, & nasopharyngeal secretions, gram stain, neutrophils in CSF, x-rays of skull, MRI, PET scan, H & P, CBC, coagulation profile, electrolyte levels, glucose, platelet count, blood culture

4. Viral Meningitis

4.1. Clinical manifestations: Headache, fever, N/V, photophobia, stiff neck

4.2. Complications Persistent headaches, mild mental impairment, & incoordination

4.3. Diagnostic studies Xpert EV, CSF sample, & polymerase chain reaction (PCR)

4.4. Collaborative care Manage symptoms Management Rest IV fluids Hypothermia

4.5. Health promotion Return to maximal neurologic functioning, manage symptoms, control pain & discomfort

4.6. Potential Nursing Diagnosis Hyperthermia Risk for Injury

5. Kaycie Marlett