INFECTION AND INFLAMMATION Interference with function because of infection or inflammation is a common occurrence. Some specific conditions include: meningitis, encephalitis, brain abscess, Guillian-Barre’ syndrome, herpes zoster, neurosyphilis, poliomyelitis, and AIDS.

MENINGITIS Meningitis is an acute infection of the meninges. It is usually caused by on of several organisms, pneumococci, staphylococci, streptococci, haemophilus influenzae, and viral aseptic agents.

Guillian-barre’ syndrome Also called acute inflammatory polyradiculopathy or postinfectious polyneuritis. It results in widespread inflammation and demyelination of the peripheral nervous system.

ENCEPHALITIS Acute inflammation of the brain and is usually caused by a virus.

BRAIN ABCESS Brain abscess is an accumulation of pus within the brain tissue that can result from a local or a systemic infection.

ACQUIRED IMMUNODEFICIENCY SYNDROME AIDS is a disease that has serious implications for the nervous system. Patients develop neurological signs and symptoms either as a result of infection with HIV itself or as a result of associated infections.

The nervous system may be affected by a variety of organisms and may suffer from toxins of bacteria and viruses. Toxins reach the nervous system from a variety of sources, including adjacent bones, blood, or lymph. Meningitis can occur as a result of an invasive procedure such as surgery.

ASSESSMENT Subjective and Objective assessments are important in any patient who has infection of the nervous system. Subjective data: history of infection, such as upper respiratory infection, and the presence of discomfort that may include headache or stiff neck. The initial onset of symptoms, any difficulty in thinking, and the presence of weakness may be important. The patient ‘s understanding of the condition should be assessed.

ASSESSMENT CONT. Objective data: behavioral signs indicatiing discomfort or disorientation as well as an inability to carry out ADL’s. the physical assessment part of the neurological assessment may reveal abnormalities; the presence of a fever, vomiting, abnormal CT results, seizures, altered respiratory patterns, tachycardia, or meningeal irritation is significant. The patient’s level of consciousness and orientation should be assessed.

DIAGNOSTICS Many of the infections of the nervous system can be diagnosed by: Examining the CSE. CT SCAN EEG

NURSING INTERVENTIONS Nursing diagnoses and interventions for the patient with an infection or inflammation are the same as those for the patient who has had a stroke, with the addition of but not limited to the following: NURSING DIAGNOSES: Hyperthermia, related to inflammatory response to CNS infection. Disturbed thought processes, related to neurophysiologic response to infection.

NURSING INTERVENTIONS Assess temperature every 2 hours and prn. Provide cooling measures prn; avoid cooling to point of shivering. Administer antipyretics as ordered. Administer antibiotics as ordered. Monitor parenteral fluids as ordered. Control exposure to extremes in temperature. Assess TPR every 2 hours as indicated. Protect patient from self injury. Introduce self to patient and establish a rapport to prevent agitation.

PATIENT TEACHING Education for the patient with an infection includes teaching about: The disease process The treatment involved Expected outcomes If the patient is seriously ill, the initial teaching focuses on the family. Other aspects of teaching for motor and sensory problems may also be relevant for the patient with an infection or inflammation, depending on the signs and symptoms demonstrated.