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Ped Neuro Alteration
Pediatric Neurological Alterations
| Question | Answer |
|---|---|
| KNOW ETIOLOGY; DIAGNOSIS; TREATMENT; NURSING INTERVENTIONS For Meningitis, Encephalitis, Seizure Disorders, Neural Tube Defects, and Cerebral Palsy | |
| What causes meningitis? | Inflammation of meninges caused by bacterial or viral or fungal organisms. HIB, Strep Pneumonia, Neisseria Meningitidis. |
| What are some organisms that cause meningitis in neonates? | GBS, E coli, Listeria monocytogenes |
| How do you prevent meningitis? | Hib vaccine, Pneumococcal, and Meningococcal vacines. |
| What are some sources of infection? | Invade Directly; Blood stream- teeth, sinuses, tonsils, ears; neuro procedures; fracture skull. |
| What are the nursing interventions for Meningitis? | Assist with lumbar puncture, Place child in isolation, admin antibiotics, manage fever, hydrate, V/S, NEURO checks, I&O's, Daily weight, HOB >30-45, monitor fontanel, decrease enviro stimuli. |
| How do you diagnosis Meningitis? | Lumbar Puncture; Analysis of CSF (Fluid cloudy; increase of WBC's and Proteins). |
| What causes Encephalitis? | Inflammation of the CNS, viral (measles, mumps, rubella, varicella, CMV, rabies, West Nile, HSV), or Bacterial (lyme disease, syphilis, TB). |
| What are some nursing measures for Encephalitis? | Same care as meningitis, Observe loss of LOC, Monitor ICP, May cause long term damage or death. |
| What are the causes of Seizure disorders? | Abnormal brain structure, fever, sepsis, metabolic abnormality. 50% have no known cause. |
| What is epilepsy? | State of 2 or more spontaneous seizures of any type that are not related to fever or to any type of acute cerebral insult. |
| What is Status Epilepticus? | Seizure lasting longer than 30 min. Serial seizures with no or short interval between seizures. |
| What are the two types of seizures? | Partial (one part of the brain); Generalized (over the entire brain alters consciousness). |
| What are the three types of Partial Seizures? | Simple partial, Complex partial (w/ impaired consciousness), Partial seizures evolving to generalized tonic-clonic convulsions (GTC). |
| What characterizes a Generalized Seizure? | Generalized toni-clonic (grand-mal), Absence (petite-mal), Atonic, Myoclonic. |
| What are some signs of Absence Seizures? | Vacant stare, Eyes roll upward, Lack of response. |
| What are the signs of Myoclonic Seizures? | Jerking of arms, shoulders, and head, usually happen in the after awakening. |
| How do you manage Seizures? | Turn on side; lower to floor; no restraints; stay w/ child; NPO; Discourage bystanders; Stay calm; Prevent injury; Airway; Oxygen if needed; V/S; Meds; Record characteristics of seizure. |
| What are important characteristics of a seizure? | Time, Responsiveness of child, movements, mobility and tone, sensation and perception, Describe behavior after return to consciousness. |
| Nursing interventions for Seizures? | Suction, ambu bag at bedside, Padded side rails, remove harmful objects, teach about meds and Side effects. |
| What are the med treatments for seizures? | Start small increase until affective or Sx's. Add another drug in first does not work. Dilantin, Tegretol, Phenobarbitol. |
| What are some non med treatments for seizures? | Ketogenic Diet (high fat, low carbs); Vagus Nerve Stimulation (implant in chest); Surgical therapy (remove area). |
| How does one get Spina Bifida? | It is a Congenital defect of the neural tube vertebral arches of the spinal vertebrae (During embryological development) |
| What are the two types of Spina Bifida and what is the difference between them? | Occulta and Cystica; Cystica involves a protrusion of spinal tissue. |
| What are the two major forms of SB cystica and what makes them different from each other? | Meningocele and Myelomeningocele. The latter has nerve roots in the protruding sac. |
| What are the nursing managements Pre-OP for Spina Bifida? | Sterile moist dressing on sac, keep clean, Prone position, observe leakage of CSF, Neuro assessment, Latex-free enviro. |
| What are the nursing managements Post-Op for Spina Bifida? | Prevent infection, Observe Signs of Infection, Monitor ICP, Observe Shunt malfunction, Prone positioning. |
| How does one get Hydrocephalus? | Congenital or acquired; It is the Dilation of ventricles caused by an imbalance in the rate of production and rate of absorption of CSF. Brain is compressed against the skull. |
| What are the treatments for Hydrocephalus? | Ventriculoperitoneal shunt or Ventriculatrial shunt. Shunt fluid to an area of the body where it can be absorbed. |
| What are some nursing managements Post-Op? | Keep Flat, Position on inoperative side, Monitor head circum., fontanels, pain, infection, drainage and gauze for halo sign (glucose). |
| What is Cerebral Palsy (CP)? | Non progressive, permanent neuromuscular disorder, Impaired movement and posture. |
| What causes CP? | Anoxia/ prematurity/ difficult delivery/ prenatal brain abnormalities; Infection; Head injury. |
| What are the different effects of Cerebral Palsy? | Quadriplegia; Diplegia (all four limbs are involved legs more severe), Hemiplegia (one side of body), Triplegia (3 limbs), Monoplegia (One limb affected). |
| What are the types of CP? | Spastic CP 70-80% cases (increased resistance to stretching); Athetoid CP 10-20% (Difficulty in controlling and co-ordinating movement); Ataxic CP 5-10% (disturbed sense of balance and depth perception). |
| What are the Treatments for CP? | Meds/Surgery/mechanical aides/Therapy Services PT, OT, Speech. |
| What are the CP treatment goals? | Optimize motor abilities; Prevent injury; Promote social and educational opportunities. |
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