Positive Brudzinski and Kernig's sign are the symptoms of — - UPUMS Nsg.Officer-2024

UPUMS Nsg.Officer-2024

Medical & Surgical Nursing

Easy

Appeared in: UPUMS Nsg.Officer-2024

Explanation

Meningitis is the inflammation of the meninges, the protective membranes covering the brain and spinal cord.
This inflammation leads to meningeal irritation, which causes a classic triad of symptoms: fever, headache, and nuchal rigidity (neck stiffness).
Brudzinski's sign (involuntary hip and knee flexion upon passive neck flexion) and Kernig's sign (pain/resistance on knee extension when the hip is flexed) are specific physical exam tests to detect this meningeal irritation.
The presence of these signs is highly indicative of meningitis.

Option A: Glomerulonephritis is an inflammation of the kidney's filtering units (glomeruli). Its symptoms are related to renal dysfunction, such as hematuria (blood in urine), edema (swelling), and hypertension, not signs of meningeal irritation.
Option C: Encephalitis is inflammation of the brain tissue itself. While it can cause neurological symptoms like confusion, seizures, or altered consciousness, Brudzinski's and Kernig's signs are specific to irritation of the meninges, not the brain parenchyma.
Option D: Pneumonia is an infection of the lungs. It presents with respiratory symptoms such as cough, fever, chills, and difficulty breathing. It does not cause the neurological signs associated with meningitis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical assessment for meningeal irritation as background academic context rather than a clinical decision trigger.
Early recognition of Brudzinski's and Kernig's signs is critical for the prompt diagnosis and treatment of bacterial meningitis, which is a neurological emergency.
A positive finding should prompt the nurse to anticipate immediate diagnostic procedures, such as a lumbar puncture (spinal tap), and the initiation of empiric antibiotic therapy to prevent severe complications like brain damage, hearing loss, or death.
What if? If a patient has a fever and headache but both Brudzinski's and Kernig's signs are negative, meningitis is less likely but cannot be completely ruled out, especially in infants and the elderly where these signs may be absent. The nurse should continue to monitor for other neurological changes and report them promptly.

How to Approach the Question

First, identify the key terms in the question stem: "Positive Brudzinski and Kernig's sign".
Recognize that these are specific, named clinical signs (eponyms) used in physical assessment.
Recall or deduce the system they test for. Both signs are classic tests for meningeal irritation.
Scan the options and identify the disease that is defined by inflammation of the meninges.
Meningitis is the inflammation of the meninges. Glomerulonephritis (kidneys), Encephalitis (brain tissue), and Pneumonia (lungs) affect different organ systems.
Therefore, associate the signs of meningeal irritation directly with meningitis.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1568-1570

E6 Medicine Harrison 22e Part 1 pp. 1161-1163, 1234-1236