Author Question: The nurse is caring for a patient with meningitis who is not responding to the prescribed antibiotic ... (Read 37 times)

littleanan · **on:** Jul 23, 2018

The nurse is caring for a patient with meningitis who is not responding to the prescribed antibiotic and whose condition continues to deteriorate.

What rationale will the nurse give the family to explain why the antibiotic is not as effective as it was hoped? A) The meninges do not have a blood supply.
B) The bloodbrain barrier prevents the antibiotics from crossing into the brain.
C) The circle of Willis redirects the antibiotic elsewhere.
D) The pressure in the hindbrain prevents entry into the skull.

Question 2

The nurse assesses that the patient is having a sympathetic response when noting what manifestations?

A) Decrease in sweating, decrease in respirations, and pupil constriction
B) Decrease in heart rate and perfusion, and an increase in inflammatory reactions
C) Increase in blood pressure, bronchodilation, and decreased bowel sounds
D) Increased motility and secretions in the GI tract, and constriction of bronchi and pupils

chloejackso · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

B
Feedback:
The bloodbrain barrier works to keep large molecules out of the brain and away from the nerves. Most antibiotics are protein bound and cannot pass through the bloodbrain barrier. When the infection becomes severe, the bloodbrain barrier will stop being effective and the antibiotics can pass into the brain. The brain has a unique blood supply to protect the neurons from lack of oxygen and glucose. After the bloodbrain barrier allows the antibiotic to pass through, the circle of Willis distributes the blood to the areas of need. If someone has an occluded carotid artery, which could build pressure up in the area, the circle of Willis can redirect the blood supply and provide a full blood supply to the affected areas.

Answer to Question 2

C
Feedback:
When stimulated, the sympathetic nervous system prepares the body to flee or to turn and fight (Figure 29.3). Cardiovascular activity increases, as do blood pressure, heart rate, and blood flow to the skeletal muscles. Respiratory efficiency also increases; bronchi dilate to allow more air to enter with each breath, and the respiratory rate increases. Pupils dilate to permit more light to enter the eye, to improve vision in darkened areas (which helps a person to see to fight or flee). Sweating increases to dissipate heat generated by the increased metabolic activity.