this lectures is purely for knowledge development

2. Subject
Adult Health Nursing
Meningitis and seizures

4. At the end of Presentation Students will be able to
 Define Meningitis.
 Discuss Sign& Symptoms of meningitis.
 Describe Causes of meningitis.
 Explain its Complications.
 Discuss Medical and Nursing Diagnosis.
 Identify Nursing management or intervention.
 Explain Treatment regimen for meningitis.
Objectives of presentation

5. Meninges.
The meninges refer to the membranous
coverings of the brain and spinal cord. There
are three layers of meninges, known as the dura
mater, arachnoid mater and pia mater. These
coverings have two major functions: Provide a
supportive framework for the cerebral and
cranial vasculature.

7.  Definition of Meningitis
Meningitis is an infection of the meninges
that cover the brain and spinal cord. it can be
caused by two kinds of micro-organisms
include Bacteria and Viruses.

8.  meningitis is characterized by the entry of
bacteria into the cerebrospinal fluid (CSF) and
bacterial growth in this compartment leading
to inflammation within the CSF and the
adjacent brain tissue.

11. Each type of meningitis has a slightly different
cause, but each ultimately acts in the same way:
A bacterium, fungus, virus, or parasite spreads
through the bloodstream until it reaches the
brain, or spinal cord. There, it sets up in the
lining or fluids around these vital body parts and
starts developing into a more advanced
infection.

12.  Non-infectious meningitis is the result of a
physical injury or other condition; it doesn’t involve
an infection ,or intrathecal cytotoxic
drugs.[methotrexate ,cytosine] .

16.  Infective tissue perfusion[cerebral] related
to infectious process and cerebral edema .
 Hyperthermia related to the infectious
process and cerebral edema
 Acute pain related to meningeal irritation.
 Impaired physical mobility related to
prolonged bed rest.
 Risk for imbalanced fluid volume related to
fever and decreased intake.

17. Nursing interventions
Assess LOC (level of consciousness),
 Reduce risk of fall to prevent patient from injury.
 Maintain a quiet,calm enviroment to prevent
agitation,which may cause an increased ICP.
 Administer medications as prescribed by
ensuring 5 rights.
 Avoid i.v fluid overload,which may worsen
cerebral edema.

18.  Initial Assessment
 Obtain a history of recent infection such as
upper respiratory tract infection.
 Assess neurological status and vital signs.
 Assess sensorineural hearing loss
[vision,hearing]cranial nerve damage [facial
nerve palsy]and cognitive function.

19.  Acute meningitis must be treated
immediately with intravenous
antibiotics,antiviral and sometimes
corticosteroids. This helps to ensure recovery
and reduce the risk of complications, such as
brain swelling and seizures. The antibiotic or
combination of antibiotics depends on the
type of bacteria causing the infection.

20.  iv treatment
 Anti viral ………injection acyclovir 500mg
 Anti bacterial ………cefhalosporin [3rd generation
of antibiotic].
 Antifungal……….Amphotericin B OR
Fluconazole
 In Non infectious meningitis …. [treat the cause,
rheumatoid arthritis ,autoimmune disease.
 Anti parasites …….largely supportive.it includes
adequate analgesia ,therapeutic CSF aspiration
and use of anti inflammatory agent such as
corticosteroids.

21.  Boyer jo Mary[2004].textbook of medical
surgical nursing philadelphia,Lippincott
Willium and Wilkins.
 Lippinoctt[2001].mannual of nursing practice
,j.p.Brothers,philadelphia.
 www.medicinenet.com
 www.ijidonline.com article

22. 2nd Topic :
Seizures

23. At the end of this session Student will be able to
 Define Seizure.
 Explain pathophysiology of Seizures.
 Explain Causes of Seizures.
 Discuss Sign & Symptoms of Seizures.
 Explain its Complications.
 Discuss medical diagnosis and management of
seizures.
 Identify Nursing Diagnosis related to seizures.
 Explain Nursing Intervention for seizures.

24. A seizure is a sudden, uncontrolled
electrical disturbance in the brain. It
can cause changes in your
behavior, movements or feelings,
and in levels of consciousness. If
you have two or more seizures or a
tendency to have recurrent
seizures, you have epilepsy.
Seizures are the
symptoms of brain
problems.

25.  During a seizure, there are bursts of
electrical activity in your brain, sort of like
an electrical storm. This activity causes
different symptoms depending on the type
of seizure and what part of the brain is
involved.

26.  Abnormal levels of sodium or glucose in the
blood.
 Brain infection, including meningitis and
encephalitis.
 Brain injury that occurs to the baby during
labor or childbirth.Brain problems that occur
before birth (congenital brain defects)Brain
tumor (rare)Drug abuse.Electric shock.
 When Meningitis causes brain swelling or
pressure,it can disrupt the brain normal
function it cause seizures.

27.  Confusion
 Changes in emotions like anxiety or
irritability
 muscles weakness or abnormal motor
activities.
 Tremors and sweating.
 Drowsiness
 Hallucinations “unreal sensation which not
exist in reality”

28. Types of
seizures
Generalized
seizures
Partial
seizures

29.  A generalized seizure occurs when the
abnormal electrical activity causing a seizure
begins in both halves [hemispheres] of he
brain at the same time.
 Generalized seizures includes
absence,atonic,clonic,tonic,myoclonic,and
febrile seizures.

30.  Generalized seizures starts by the activation of group
neuron.its involves both hemispheres.
1,Tonic phase
 in the tonic phase the body becomes entire rigid.
2.Clonic phase
 there is uncontrolled jerking alternating contraction
and relaxation, causing a reciprocating
movement,which could be bilaterally symmetrical or
‘running' movements.
3.Absence seizures
 Brief and abrupt loss of consciousness. Usually of short
duration 5-10sec ,no loss of postural control.
4, Myoclonic.
 it has short episode of muscles contractions for several
minutes .it occur after wakening .it may occur at any
age.
5,Atonic .it is also called drop attack.have no muscle
tone.

32.  Partial seizures happen when unusual
electrical activity affects a small area of the
brain .when the seizures does not effect
awareness ,it is known as a simple partial
seizures and it effecting the muscles of the
body .

33. Breathing in food or saliva into the lungs
during a seizure, which can cause
aspiration pneumonia.
Injury from falls, bumps, self-inflicted
bites, driving or operating machinery
during a seizure.Permanent brain
damage (stroke or other damage)Side
effects of medicines.
Encephalitis
Oral trauma

34.  HISTORY
 Physical examination
 Blood test
 EEG [electroencephalogram]
 MRI [magnetic resonance imaging]
 CT scan
 SPECT[single photon emission computerized
tomography
 LP
EEG result
show changes
in brain
activity.

35.  Pass iv line.
 Anticonvulsant –carbamezapine 500mg
 Valproic acid.
 Antiseizures –phenytoin 50mg iv
 tab Phenobarbital.

36. Risk for trauma or suffocation related to
loss of large or small muscle
coordination.
Risk for ineffective airway clearance
related to neuromuscular impairment.
Situational low self-esteem related to
stigma associated with the condition.
Deficient knowledge related to
information misinterpretation.
Anxiety related to change in activities.

37.  Remove near by objects and stay with the
patient.
 Position the patient to maximize the
ventilation.
 Promote airway clearance to prevent from
tongue bite.
 Provide oxygen if necessary.
 The bed is placed in a low position with side
rails up to reduce risk of fall.
 Keep NPO to prevent aspiration.
 Educate the patient and its family,provide
psychological support.

38.  www.hopkinmedicine.org
 www.cedars-sinai.org health library
 www.medicalnewstoday.com articles
 www.msdmanuals.com
 www.mayoclinic.org