LESSON PLAN ON MENINGITIS

Programme Course Topic Group No of students Venue Date Duration Method of teaching Av aids

: Bsc(N) : Medical Surgical Nursing : MENINGITIS : Bsc(N) -II : 50 : Lecture hall- 5 :10/10/2009 : 1hrs : Lecture cum discussion : black board, OHP. Chart. :Radhika.A.B. year

Name of the student teacher

Central objectives: At the end of the class the students will be able to gain in-depth knowledge on Meningitis & develop desirable skill & attitude while taking care of Meningitis patients Contributory objectives: At the end of the class the students will be Define Meningitis Discuss the incidence of Meningitis List down the types of Meningitis Enumerate the causes of Meningitis Describe the pathophysiology of Meningitis. Explain the clinical manifestation of Meningitis Identify the diagnostic investigation of Meningitis Elaborate the management of Meningitis.

SL No

TIME

SPECIFIC OBJECTIVE

CONTENTS

TEACHER ACTIVITIES

LEARNERS ACTIVITIES

AV.AIDS

EVALUATION

MENINGITIS
5min

- introduce the topic Meningitis and Its incidence to the students.

MEANING Meningitis is an inflammation of the meninges, the membranes that surround the brain. There are three meninges, including the following: Dura Mater - the outside membrane that adheres to the inside of the skull. Arachnoid - the middle membrane. Pia Mater - the innermost membrane, which adheres to the brain. INCIDENCE Between 1992 &1996 there was a 28% increase in the number of new cases reported in the 12-29year old group. Outbreak of N.meningities infection are most likely to accur year around the peak incidence is in the winter in early spring. CAUSES AND TYPES There are two distinct types of meningitis, each with different causes: VIRAL - CAUSED BY A VIRUS (ASEPTIC) Viral meningitis is more common than bacterial meningitis, although rarely life threatening. Viral meningitis can be caused by different viruses, and is spread between people by coughing or sneezing, or through poor hygiene. Other germs can be found in sewage polluted water.

Writes the topic on the black board. & Introduces the topic by narration.

Listens

Black board

What is

Meningitis

5min

-To explain in detail Regarding the Cause and risk factor of meningitis.

Explains the causes of

Listening & Notes taking

OHP

What are the causes of

meningitis

meningitis?

Viral meningitis cannot be helped by antibiotics. Recovery is normally complete, but headaches, fatigue, and depression may persist.

BACTERIAL - CAUSED BY A BACTERIUM (SSEPTIC) Bacterial meningitis, although rare, may be fatal. Bacteria may be spread through the exchange of respiratory and throat secretions, such as coughing and kissing, but they cannot live outside the body for long. They cannot be picked up from water supplies, swimming pools, buildings, etc. Many species of bacteria can cause meningitis, but three types account for about 80 percent of cases, including the following:
o

Neisseria Meningitidis (Meningococcus) Meningococcus is found in the nasopharynx of about 5 percent of the population and is spread by respiratory droplets and close contact. For unknown reasons, only a small fraction of carriers develop meningitis. Meningococcal meningitis occurs most often in the first year of life, but may also occur in closed populations, such as schools. Haemophilus Influenzae Type B Haemophilus influenzae type b accounts for most meningitis in children older than 1 month, but usually not in adults unless there is a predisposing factor such as head trauma or a compromised immune system. Vaccines against this type are given to children as part of a routine vaccination program.

Streptococcus Pneumoniae (Pneumococcus) Pneumococcus is the most common cause of adult meningitis. Those at high risk may include persons with chronic ear infections, sinus infections, closed head injury, recurrent meningitis, and pneumococcal pneumonia.

There are several ways that the infection can reach the brain, including the following: through the bloodstream from another infected part of the body through the bones of the skull from infected sinuses or inner ears from a head injury, such as a fractured skull or penetrating wound after surgery or extended hospitalization from a weakened immune system as a result of chronic kidney failure

5min

PATHOPHYSIOLOGY Meningeal infection generally originate in one of two ways in detail about through the blood stream as a consequence of other infection or by direct extension such as it might accur after a traumatic pathophysiolo injury to the facial bones or secondary to invasive procedures. gy of -To describe meningitis.

Explains the pathophysiol ogy of

Listens and discusses

OHP

Explain in detail about The pathophysiolo gy of

meningitis

meningitis?

Causative organism enters the blood stream Crosses the blood brain barrier Cause the inflammatory reaction in the meninges Inflammatory cellular material from affected meningeal tissues enters and accumulates in subarachnoid space Inflammation of the subarachnoid space and pia mater accur Increases CSF cell count Increased intracranial pressure -To explain THE SIGNS AND SYMPTOMS OF MENINGITIS The following are the most common symptoms of in detail meningitis. However, each individual may experience symptoms about signs& differently. Symptoms may include: fever symptoms headache of nausea and vomiting stiff neck

5min

Explains the signs and symptoms of

Listens and takes notes.

Chart

What are signs and symptoms of

meningitis.

meningitis?

meningitis.

photophobia (low tolerance to bright light) confusion joint aches or pains drowsiness seizures

Symptoms for children may also include: fever high-pitched cry pale, blotchy skin color not wanting to eat vomiting fretful and fussy arching back difficult to wake It is important to note that these symptoms may not occur all at once, nor in everyone who contracts meningitis. The symptoms of meningitis may resemble other conditions or medical problems. Always consult your physician for a diagnosis.
Explains the 10min Listens and discusses Black board What are the diagnostic measures of

- enumerate In detail about Diagnosis of meningitis.

DIAGNOSIS In addition to a complete medical history and physical examination, diagnostic procedures for meningitis may include the following: Lumbar Puncture (Spinal Tap) - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain

investigation technique for

meningitis?

meningitis .

and spinal cord. Blood Testing Computed Tomography Scan

10min

Enumerates the treatment modalities of meningitis.

TREATMENT FOR MENINGITIS Treatment may include: Bacterial Meningitis Treatment for bacterial meningitis usually involves intravenous (IV) antibiotics. The earlier the treatment is initiated, the better the outcome. Viral Meningitis Treatment for viral meningitis is usually supportive (aimed at relieving symptoms). With the exception of the herpes simplex virus, there are no specific medications to treat the organisms that cause viral meningitis. Fungal Meningitis An intravenous anti-fungal medication may be administered to treat fungal meningitis. Tuberculous (Tb) Meningitis A long course (one year) of medications is recommended for persons who develop TB meningitis. The therapy usually involves treatment with several different medications for the first few months, followed by other medications. supportive therapy for meningitis While a person is recovering from meningitis, other therapies may be initiated to improve healing and comfort, and

Explains the Treatment modalities of

Listens & Notes taking.

Chart

Explain the treatment modalities of

Meningitis.

meningitis.

provide relief from symptoms. These may include the following: bed rest medications (to reduce fever and headache) supplemental oxygen or mechanical ventilation (respirator) may be required if you become very ill and have difficulty breathing In addition, supplemental oxygen or mechanical ventilation (respirator) may be required if pt become very ill and have difficulty breathing. Prevention Of Meningitis Several vaccines are currently available to prevent some of the bacterial organisms that can cause meningitis, including the following: Haemophilus influenzae type b vaccine is given as a three or four part series during your child's routine immunizations starting at 2 months. Although pneumococcal vaccines have been used for older children and adults for many years, the American Academy of Pediatrics (AAP) now recommends a new form of pneumococcal vaccine for all children younger than age 2. This vaccine is called pneumococcal conjugate vaccine (PCV7). The AAP also recommends that PCV7 be given to all children ages 24 to 59 months of age that are at very high risk for pneumococcal infection. This includes children who have weakened immune (infection-fighting) systems, such as those with sickle cell disease and HIV infection (human immunodeficiency virus). PCV7 can be given along with other childhood vaccines and is recommended at the following ages: 2 months

4 months 6 months 12 to 15 months Children who are sick or have a fever should wait until they are well to get the PCV7 vaccine. Children who have had a prior reaction to any type of pneumococcal vaccine should not receive PCV7. For Neisseria meningitis (meningococcal meningitis), a meningococcal vaccine is currently only used for highrisk groups. Immunization for the bacteria is not widespread due to its uncommon occurrence. Individuals who may require immunization include the following: o asplenic children (children without a spleen) o college students (immunization of college students is recommended by the American College Health Association) o military recruits o individuals who are traveling to countries where the incidence of meningococcal infections is higher (parts of Africa) o treatment of family members or close contacts of individuals with meningitis may be necessary if the following types of bacterial meningitis are present: Haemophilus influenzae type b Neisseria meningitiis (meningococcal)

5min

Nursing Management Of Meningitis Educate the patient and family members regarding personal hygiene. Administer medication in time Reassure the family members and patient SUMMARY Meningitis is an inflammation of the meninges, the membranes that surround the brain. Between 1992 &1996 there was a 28% increase in the number of new cases reported in the 12-29year old group. Outbreak of N.meningities infection are most likely to occur year around the peak incidence is in the winter in early spring. Meningeal infection generally originate in one of two ways through the blood stream as a consequence of other infection or by direct extension such as it might accur after a traumatic injury to the facial bones or secondary to invasive procedures. CONCLUSION At the end of the class the student have gain knowledge about meningitis and its types, risk factors, clinical manifestations, diagnosis, and its management EVALUATION Short answer question 5 x 3 = 15. 1) Meningitis 2) Management of patient with meningitis. 3) Treatment and nursing management of meningitis.

Discuss the nursing management

Black board

Explain in detail about the nursing management of patients with

5min

meningitis.

3min

5min

2min

ASSIGNMENT Write an assignment on nursing care plan of patient with meninjitis. BIBLIOGRAPHY 1. Students bibliography Brunner and suddarths, TEXT BOOK OF MEDICAL SURGICAL NURSING, 10TH edition, Lippincott Williams and Wilkins. Lippincott, MANNUAL OF NURSING PRACTICE, 8th edition, Lippincott Williams and Willkins.

2. Teachers bibliography Brunner and suddarths, TEXT BOOK OF MEDICAL SURGICAL NURSING, 10TH edition, Lippincott Williams and Wilkins. Lippincott, MANNUAL OF NURSING PRACTICE, 8th edition, Lippincott Williams and Willkins. Long & Phipps -Medical Surgical Nursing Luckman &Sorenson -Medical Surgical Nursing