Neuro Case Study

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Neurological Disorder Case Study - Meningitis
The nurse is caring for a 21-year-old female college student who presents to the emergency department (ED) with complaints of “bad” headache pain, nausea, vomiting and neck tightening. She states, “My sinuses were bothering me last week, but I thought I was getting better until this morning.” No past surgical history noted, has recurrent sinus infections, and denies drug use, but is a social drinker on the weekends.

Physical assessment findings are as follows:
T – 100.8 F, P – 104, R – 24, B/P – 122/78
Alert and oriented X3 – person, place and time with periods of confusion and agitation over last 4 hours
Lung sounds slightly diminished at the bases
Mucous membranes dry and capillary refill <3 seconds
Assessment of cranial nerve XI elicited severe pain response
Pain to neck worsening and unequal pupillary responses are noted 4 hours after admission

Lumbar puncture was prescribed and results are:
Turbid appearance
WBC - 560 cells/µL
Glucose - 20 mg/dL
Protein - 510 mg/dL

Other diagnostic test results
CT scan identified no obstruction to flow of CSF

Define the key terms below: * Meningitis - see pgs. 1451 – 1455 in Lewis (8th edition)

Critical Thinking Questions: 1. Define meningitis? 2. What are the risk factors for meningitis for this client? 3. Which clinical manifestations are essential for the nurse to note at this time? 4. What additional assessment data should the nurse obtain? 5. What diagnostic findings differentiate meningitis from encephalitis? 6. What classes of medications would most likely be prescribed for a client with acute bacterial meningitis and identify 2 nursing implications for each medication listed (e.g., Verify allergies, assess renal and hepatic function (if risk for toxic effects on these systems)? 7. Explain essential nursing

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