Kep MENINGITIS Peradangan pada jaringan pembungkus otak (selaput meningen)
Penyebab : Bakteri, Virus, atau Jamur
Infeksi saluran nafas atas
Invasi ke dalam aliran darah (bakteremia) Cidera kepala cidera meningen Kanker & penyakit autoimun (SLE) Mikroorganisme Penyebab Meningitis Pneumococcal, Streptococcus pneumoniae (38%)
Meningococcal, Neisseria meningitidis (14%)
Haemophilus influenzae (4%)
Staphylococcal, Staphylococcus aureus (5%)
Tuberculous, Mycobacterium tuberculosis
MENINGITIS Istilah yang sering dijumpai pada meningitis adalah : Meningitis Bacterial Meningitis Virus Meningitis Aseptik Septekemia Meningitis Bakterial Potentially life threatening disease. Can affect all age groups but some are at higher risk. Treatment available : antibiotics as per causative organism Humans are the reservoir . Pneumococcal meningitis is the most common type. Meningitis Virus Etiological Agents Enteroviruses (Coxsackie's and echovirus) most common. Reservoirs ‐ Humans for Enteroviruses, Adenovirus, Measles, Herpes Simplex, and Varicella ‐ Natural reservoir for arbovirus birds, rodents etc. Modes of transmission Primarily person to person and arthopod vectors for Arboviruses Incubation Period Variable. For enteroviruses 3-6 days, for arboviruses 2-15 days Treatment ‐ No specific treatment available. ‐ Most patients recover completely on their own Meningitis Aseptik Definition A syndrome characterized by acute onset of meningeal symptoms, fever, and cerebrospinal fluid pleocytosis, with bacteriologically sterile cultures. Laboratory criteria for diagnosis ‐ CSF showing ≥ 5 WBC/cu mm ‐ No evidence of bacterial or fungal meningitis. Confirmed A clinically compatible illness diagnosed by a physician as aseptic meningitis, with no laboratory evidence of bacterial or fungal meningitis Aseptic meningitis is a syndrome of multiple etiologies, but most cases are caused by a viral agent Septikemia Meningitis - bacteria enter the blood stream and travel to the meninges and cause inflammation. Septicaemia - when bacteria are present in the blood stream they can multiply rapidly and release toxins that poison the blood. (The rash associated with meningitis is due to septicaemia.) Meningitis and septicaemia often occur together. Meningitis and meningococcal septicaemia may not always be easy to detect (can be similar to flu) It is important to remember that symptoms do not appear in any particular order and some may not appear at all Complication Septic shock - DIC Cerebral oedema Seizures Arteritis/venous thrombosis Subdural effusions Hydrocephalus Brain abscess & damage Deafness Pengkajian Pemeriksaan fisik Pemeriksaan darah Pemeriksaan CSS Kultur darah / CSS Counter Immuno Electrophoresis (CIE) Deteksi antigen bakteri pada cairan tubuh Penaatalaksanaan Umum Antimikroba segera Ex : penisilin, ampisilin, kloramfenikol, atau satu jenis sefalosporin Rehidrasi cairan IV Kontrol kejang dg anti-kejang (Ex: Diazepam, fenitoin) Mengurangi edema serebri dg diuretik osmotik (Ex : manitol) Masalah keperawatan Hipertermia Nyeri akut Resiko gangguan perfusi serebral Mual Nutrisi kurang dari kebutuhan Resiko cidera Intervensi Keperawatan Pengkajian tanda vital dan GCS secara intens Pemberian O₂ tambahan Pemantauan O₂ perifer dan arteri Pemantauan tekanan arteri waspada syok Catat : vasokonstriksi, sianosis menyebar, ekstrimitas dingin. Penggantian cairan IV perhatikan resiko edema serebri. Peningkatan kenyamanan kebersihan mulut & kulit Penatalaksanaan kejang atau saat penurunan kesadaran. THANK YOU
The Relationship Between Dietary Patterns and Nutritional Knowledge With The Nutritional Status of Bajo Tribe Pregnant Women in Duruka District, Muna Regency