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INFECTIVE CONDITIONS - Coggle Diagram
INFECTIVE CONDITIONS
BACTERIAL MANINGITIS:
PATHOPHYSIOLOGY:
Meningeal infections generally originate in one of two ways: through the bloodstream or by direct spread.One of the causative organism enters the bloodstream, it crosses the blood brain barrier and proliferates in the cerebrospinal fluid.The host immune system stimulates the release of cell wall fragments and lipopolysaccharides, facilitating inflammation of the subarachnoid and pia mater.Because the cranial vault contains little room for expansion, the inflammation may cause increased intracranial pressure.CSF circulates through the subarachnoid space, where inflammatory cellular materials from the affected meningeal tissue enter and accumulate.
SIGNS AND SYMPTOMS:
-Headache
-stiff and painful neck
-Positive Kernig’s sign. When the patient is lying with the thigh flexed on the abdomen, the leg cannot be completely extended.
.- Extreme sensitivity to light
-Skin lesions
-Disorientation and memory impairment
-Seizures.
NURSING CARE PLAN:
NURSING DIAGNOSIS:
Risk for Infection Transmission related to contagious nature of organism
Acute Pain related to headache, fever, neck pain secondary to meningeal irritaiton
Risk for Impaired Skin Integrity related to immobility, dehydration, and diaphoresis
Anxiety related to treatment and risk of death
GOALS:
Protection against injury.
Prevention of infection.
Restoring normal cognitive functions.
Prevention of complications.
NURSING INTERVENTIONS:
Assess neurologic status and vital signs constantly
Assess blood pressure (usually monitored using an arterial line) for incipient shock
Reduce high fever to decrease load on heart and brain from oxygen demands.
Protect the patient from injury secondary to seizure activity or altered level of consciousness (LOC).
Institute infection control precautions until 24 hours after initiation of antibiotic therapy
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EVALUATION:
Avoidance of injury
Avoidance of infection.
Restoration of normal cognitive functions.
Prevention of complications
ENCEPHALITIS:
PATHOPHYSIOLOGY:
inflammation and edema occur in infected areas throughout the cerebral hemispheres, brain stem, cerebellum, and, occasionally, spinal cord. Petechial hemorrhages may be present in severe infections.
SIGNS AND SYMPTOMS:
Headache
Fever or hyperthermia
Muscle or joint pain
Fatigue
Siesures
Decline in mental state, such as confusion, hallucinations
Coma
NURSING CARE PLAN:
NURSING DIAGNOSIS:
Hyperthermia secondary to infective procecess of encephalitis as evidenced by rapid breathing, profuse sweating and chills.
Ineffective tissue purfusion related to cerebral edema and increased intracranial pressure related to the process of ancephalitis as evidenced by drowsiness, hallucinations and memory loss.
GOAL:
Pt. Maintains cerebral tissue perfusion
Within 4 hours the Pt. Will have a stabilized temperature and within normal ranges.
NURSING INTERVENTIONS:
Assess Pt. Vital signs at least every 4hrs to make a proper diagnosis.
Offer a tepid sponge bath to facilitate the body in cooling down.
Elevate the head of the bed to facilitate proper expansion of the lungs.
Administer prescribed antibiotics to treat underlying infections.
Administer osmotic diuretics to allow flow of blood to the brain and reduce cerebral edema.
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BRAIN ABSCESS:
PATHOPHYSIOLOGY:
A brain abscess is a collection of infectious material within the tissue of the brain.
Bacteria are the most common causative organisms. An abscess can result from intra-cranial surgery, penetrating head injury, or tongue piercing.
SIGNS AND SYMPTOMS:
Headache
Fever, vomiting and decreasing vision.
As the abscess expands, symptoms of increased intracranial pressure (ICP) such as decreasing level of consciousness and seizures are observed.
NURSING CARE PLAN:
NURSING DIAGNOSIS:
Fever related to infecton secondary to abnormal body temperature ranges and skin flushes
Disturbed Sensory Perception related to increased intracranial pressure evidenced by Altered sensorium.
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NURSING INTERVENTIONS:
Perform tepid sponge.
Maintain adequate fluid intake as tolerated.
Administer antibiotics as indicated to prevent Seizures.
Administer antipyretics as indicated.
Assess level of consciousness using GCS
Assess for signs of cerebral edema such as dizziness, headache, irregular breathing, neck pain, nausea or vomiting
Elevate head of bed up to 30° to 45° with the client’s head in neutral position.
Maintain a quiet environment and keep the lights dim..
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