Page 2034 - Saunders Comprehensive Review For NCLEX-RN

Scale.
3. Assess for mental status changes and personality and
behavior changes.
4. Assess for signs of increased ICP.
5. Assess for the presence of nuchal rigidity and a
positive Kernig’s sign or Brudzinski’s sign,
indicating meningeal irritation (Fig. 58-3).
6. Assist the client to turn, cough, and deep-breathe
frequently.
7. Elevate the head of the bed 30 to 45 degrees.
8. Assess for muscle and neurological deficits.
9. Administer acyclovir as prescribed (usually the
medication of choice for herpes encephalitis).
10. Initiate rehabilitation as needed for motor dysfunction
or neurological deficits.

XIX. West Nile Virus Infection

A. Description
1. A potentially serious illness that affects the CNS
2. The virus is contracted primarily by the bite of an
infected mosquito (mosquitoes become carriers when
they feed on infected birds).
3. Symptoms typically develop between 3 and 14 days
after being bitten by the infected mosquito.
4. Neurological effects can be permanent.
B. Assessment
1. Many individuals will not experience any symptoms.
2. Mild symptoms include fever; headache and body
aches; nausea; vomiting; swollen glands; or a rash on
the chest, stomach, or back.
3. Severe symptoms include a high fever, headache, neck
stiffness, stupor, disorientation, tremors, muscle
weakness, vision loss, numbness, paralysis, seizures,
or coma.
C. Interventions are supportive; there is no specific treatment for the
virus.
D. Prevention
1. Use insect repellents containing DEET
(diethyltoluamide) when outdoors and wear long
sleeves and pants and light-colored clothing.
2. Stay indoors at dusk and dawn when mosquitoes are
most active.
3. Ensure that mosquito breeding sites are eliminated,
such as standing water and water in bird baths, and
keep wading pools empty and on their sides when
not in use.
XX. Meningitis
A. Description

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