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1. Question
The nurse is evaluating the status of a client who had a craniotomy 3 days ago. Which assessment finding would indicate that the client is developing meningitis as a complication of surgery?
Correct
Answer: Option 3 is the correct answer.
Rationale: Signs of meningeal irritation compatible with meningitis include nuchal rigidity, a positive Brudzinski’s sign, and positive Kernig’s sign. Nuchal rigidity is characterized by a stiff neck and soreness, which is especially noticeable when the neck is flexed.Kernig’s sign is positivewhen the client feels pain and spasm of the hamstringmuscles when the leg is fully flexed at the knee and hip. Brudzinski’s sign is positive when the client flexes the hips and knees in response to the nurse gently flexing the head and neck onto the chest. A Glasgow Coma Scale score of 15 is a perfect score and indicates that the client is awake and alert, with no neurological deficits. Test-Taking Strategy: Focus on the subject, a client’s diagnosis of meningitis. You can eliminate options 1, 2, and 4 because they are comparable or alike and are normal findings.
Incorrect
Answer: Option 3 is the correct answer.
Rationale: Signs of meningeal irritation compatible with meningitis include nuchal rigidity, a positive Brudzinski’s sign, and positive Kernig’s sign. Nuchal rigidity is characterized by a stiff neck and soreness, which is especially noticeable when the neck is flexed.Kernig’s sign is positivewhen the client feels pain and spasm of the hamstringmuscles when the leg is fully flexed at the knee and hip. Brudzinski’s sign is positive when the client flexes the hips and knees in response to the nurse gently flexing the head and neck onto the chest. A Glasgow Coma Scale score of 15 is a perfect score and indicates that the client is awake and alert, with no neurological deficits. Test-Taking Strategy: Focus on the subject, a client’s diagnosis of meningitis. You can eliminate options 1, 2, and 4 because they are comparable or alike and are normal findings.
Craniotomy:
Craniotomy is the surgical procedure in which a part of the
bone scull is removed to allow the surgeon to have access to the brain.
Special surgical apparatus are used to remove the part of
the bone called the bone flap. The bone flap is temporarily removed until the
surgery is completed and is then repositioned with the use of special titanium
plates.
Types of craniotomy and neuronavigation.
There are several types of craniotomy depending on the
location of the lesion, for instance:
Classical craniotomy.
Endoscopic craniotomy.
Key hole craniotomy.
Posterior sigmoid
Translabyrinth craniotomy.
Hypo-occipital craniotomy.
Endoscopic craniotomy is another type of craniotomy which
involves inserting an endoscopic camera into the brain through a small incision
in the scalp. It is usually used for intraventricular tumors or for endoscopic
third ventriculostomy in cases of hydrocephalus.
Craniectomy is a similar procedure involving the permanent
removal of a part of the skull. This is usually performed where there is
swelling of the brain before or after a brain surgery and in cases of
infection.
