Nootan college of nursing
VISNAGAR
SUB:- child health nursing
TOPIC: - teaching practice ON “meningitis ”
SUBMITTED TO: SUBMITTED BY:
Mrs.Daxa.P.Patel Mrs. Sayma Mansuri
Asso.Professor 2nd Year M.Sc. Nursing
NCN Roll no.- 03
INTRODUCTION :
Name of the Student: - Mrs. Sayma Mansuri
Name Of The Guide:- Mrs. Mahalakshmi. B.
Topic: - Rheumatic Heart Disease
Venue: - B.Sc. Nursing 3rd year classroom.
Class Taught: - Third year B.Sc. Nursing.
Method Of Teaching:- Lecture Cum Discussion.
Audio Visual Aids: - Power Point Presentation, Black Board.
PREVIOUS KNOWLEDGE OF THE GROUP:-
The Group have limited knowledge regarding meningitis .
GENERAL OBJECTIVES:-
At the end of this topic , Group will understand about the meningitis .
SPECIFICS OBJECTIVES:-
To explain the Itroduction of meningitis..
To discuss definition of meningitis.
To discuss etiology of meningitis ..
To explain the classification of meningitis.
To explain the diagnostic evaluation of meningitis
To explain the management of meningitis.
To explain the complication of meningitis.
SPECIFIC TIME CONTENT TEACHING A.V. AIDS EVALUATIO
OBJECTIVE: LEARNING N
ACTIVITY
Lecture cum Power point What is
01 To explain about 5 min
MENINGITIS discussion meningitis?
the meningitis.
Meningitis is the medical term for inflammation of the
tissues that surround the brain and spinal cord. The
inflammation is most commonly caused by virus or a
bacterium, which travels from infection in another part
of the body through the blood stream to the
meningitis.
DEFINITION:-
02 To explain about Lecture cum Define the
the definition of 2 min discussion Power point meningitis?
Meningitis is defined as an inflammation of the meanings
meningitis.
(tissues) covering the brain and spinal cord.
03 To explain about CLASSIFICATION:- What are the
the classification of 5 min Lecture cum classification of
meningitis. Depending upon the etiological agent, meningitis is 3 types:- discussion Power point meningitis?
A} Bacterial or pyogenic meningitis
B} Aseptic meningitis
C} Tubercular meningitis
1] BACTERIAL OR PYOGENIC MENINGITIS:-
It caused by widely variety of pyogenic bacterias like
haemophilus influenza, meningococcus, pneumococcus,
streptococcus etc….
Haemophilus influenza and meningococcus together
account 70% of all cases of bacterial meningitis.
Bacterial meningitis is a complication of bacteremia
occuring due to – pneumonia, empyema, osteomyelitis
and endocarditis.
2] ASEPTIC MENINGITIS:-
It is caused by virus , fungi or protozoa. It symptoms are
similar to common flu.
3] TUBERCULAR MENINGITIS:-
To explain about What are the
04 the causes of 10 min It caused by mycobactrium tuberculosis Lecture cum Power point causes of
meningitis. discussion meningitis?
ETIOLOGY:-
Acute bacterial meningitis may caused by bacteria like
E.coli, pseudomonas aeruginosa, Klebsiella aerogenes ,
strptococcus fecalis, staphylococcus aureus and
Hemolytic streptococcus are responsible for meningitis
in neonates.
Infants younger than 2 months, Group B streptococci and
E-coli:- 70%
Infants above the age of 3 months, infection is mainly
caused by Haemophilus influenza, pneumococcai,
Meningococcai and certain virus, fungi and protozoa
05 To explain about
PREDISPOSING FACTORS:-
the predisposing 5 min Lecture cum Power point What is
factor of Children on immunosuppressive drugs discussion predisposing
meningitis. factors of
Immunocompromised patient like babies of HIV meningitis?
positive mothers
Meningitis is common in infant and young children
because their immune mechanism is immature
Patient with diabetes mellitus and malignancies.
CLINICAL FEATURES: -
06 To explain about What are the
the clinical features 15 min The typical symptoms of meningitis are rarely seen in Lecture cum Power point clinical features
of meningitis. children less than two years of age. The onset of symptoms discussion of meningitis?
is acute in case of bacterial meningitis but insidious in case
of viral meningitis.
The clinical features in
NEONATES
Poor feeding
Vomiting
Diarrhea
Lethargy
Weak cry
Sleepiness
INFANTS OLDER 3 MONTHS
Fever
Irritability
Seizures
High pitch cry
CHILDREN OLDER THAN 3 YEARS
Fever, chills, malaise because of infection.
Headache, vomiting, papilledema because of increased
intracranial pressure.
There are signs of meningeal irritation like…..
Nuchal rigidity
Positive Brudzinski’s sign – with patient in supine position ,
on passive flexion of neck there is involuntary bending of
hip and knees.
Positive kerning’s sign- with patient in supine position and
hips flexed , passive straightening of the leg at knee causes
active resistance and back pain.
opisthotonus position
Photophobia , diplopia and other visual problems due to
cranial nerve irritation.
Delirium , deep coma or stupor due to cerebral edema and
increased intra cranial pressure.
VIRAL MENINGITIS
Generalized myalgia
Pharyngitis
What arethe
07 To explain about 5 min DIAGNOSTIC EVALUTION:- Lecture cum Power point diagnostic
the diagnostic test discussion evaluation of
of meningitis. meningitis?
i. Lumbar puncture
ii. CSF examination
iii. CSF culture is positive
iv. Blood examination
v. Blood culture
vi. CT scan & MRI
08 To explain about 10 min MANAGEMENT:- Lecture cum Power point What is the
the management of discussion management of
meningitis. meningitis?
1) SPECIFIC TREATMENT:-
Treatment is started with Antibiotics , on the basis of
culture and sensitivity report of CSF.
Penicillin with third generation cephalosporin.
Vancomycin with 3rd generation cephalosporin.
Cefotaxine/ Ceftriaxone with Aminoglycocides.
Duration of antibiotic Therapy
• 7-14 days depending upon the type of organism.
• 3 weeks in case of gram negative bacteria.
2) SYMPTOMATIC TREATMENT:-
a) Seizure management:-
For controlling seizures , phenobarbitone 10 mg is given
intravenously.
Dilantin can also be given in a dose of 7 mg/kg body
weight. Diazepam 2.5 mg may be given to reduce
restlessness.
b) Management of increased intracranial pressure:-
Mannitol 0.5mg/kg body weight as 20% solution is
administered .
Frusemide 1mg/kg body weight may be given.
c) Fever and headache:-
Aspirin or acetaminophen may be used to manage fever and
headache.
3) Supportive care:-
Iv fluids to maintain fluid electrolyte balance.
Monitoring of neurological status.
Patients with specific shock require vasoactive drugs like
epinephrine and dopamine.
NURSING MANAGEMENT:- Lecture cum Power point What is nsg
To explain about 10 min discussion management of
09 the nursing of 1. ISOLATE THE CHILD:- meningitis?
meningitis.
When child is admitted with suspected meningitis , the
nurse should isolate the child , in order to protect others
patients from injection.
Nobody with upper respiratory tract infection should attend
the child as he is already infected.
2.ADMINISTRATION OF DRUGS:-
Antibiotics and anticonvulsants should be administered as
prescribed by the physician. Intravenous antibiotics are
given for minimum 7-10 days.
3.CONTROL SEIZURES AND PROTECT THE CHILD FROM
INJURY:-
Monitor the child’s level of consciousness.
If the child’s condition permits then nasogasrtic feeding
can be given.
Maintain intake and output record to assess for any fluid
retention, impending shock and SIADH.( Syndrome of
inappropriate anti diuretic hormone).
In presence of SIADH , administer only 2/3rd of the total
fluid requirement.
4.PROVIDE COMFORT AND REST:-
The child may have photophobia so avoid bright light in
patient’s room.
Position the child on side so as to prevent any aspiration.
Provide passive exercises to the child.
Head and neck should be supported while lifting the child.
5. MONITOR THE CHILD’S CONDITION:-
Vital signs should be monitored frequently.
Assess the neurological status and level of consciousness
frequently.
Assess the fontanels and measure head circumference daily.
Maintain a record of head circumference of the child.
COMPLICATION :-
10 To explain about
the complication of 5 min Lecture cum Power point What are the
meningitis.
Subdural effusion discussion complication of
meningitis?
Cerebral infraction
Encephalitis
Endocarditis
Brain abscess
Hydrocephalus
BIBLIOGRAPHY:-
I. Parul dutta., “PEDIATRIC NURSING” 2nd edition,2009.
published by, jaypee brothers medical
publisher(P)New Delhi.
II. Marlow R.Dorothy, “ TEXT BOOK OF PEDIATRIC”
six edition 2010 published by
Elsevier division of reed india.
III. Rimple Sharma“ESSENTIALS OF PEDIATRIC NURSING”
1st edition, published by jaypee brothers
medical publisher(P) LTD New Delhi
IV. Tambuwadkar R.S“PEDIATRIC NURSING”3rd edition,
2007 Published by vora medical publication
Bombay.