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Pediatrics:
Nuerosensory and musculoskeletal disorder
| Question | Answer |
|---|---|
| What is meningitis? | inflammation of the meninges - protective membranes of the brain and spinal cord. |
| Which are the type of meningitis? | - viral: most common, resolves w/out treatment - bacterial: contagious, high mortality rate |
| What are risk factors for viral meningitis? | viral illnesses |
| What are risk factors for bacterial meningitis? | Upper bacterial resp infections, immunosuppression, injuries that provide direct CSF access, overcrowding |
| What are s/s of meningitis? | HA, N/V, fever and chills, photophobia, nuchal rigidity, +Bruzinski and Kernig's signs, seizures |
| What is the most definitive diagnostic procedure for meningitis? | CSF analysis |
| What are nursing interventions to lumbar puncture for CSF? | NPO 6-8hr, child empties bladder, in fetal position, sedate PRN, clean skin and apply EMLA, take CSF pressure reading |
| How long should child remain in bed in a flat position to prevent leakage that can result in spinal headache? | 4-8 hr |
| What are CSF findings indicative of meningitis? | - cloudy CSF = bacterial, clear CSF = viral - decreased glucose = bacterial - elevated WBC, protein, CSF pressure |
| What are nursing interventions for meningitis? | isolate pt, frequent VS and neuro status, initiate IV fluids, maintain safety, administer Rx meds, decrease environmental stimuli |
| What is major concern of meningitis? | increased ICP (preventions: positioning, avoidance of coughing and straining). |
| What vaccines protect infants from bacterial meningitis? | - PCV (pneumococcal vaccine) - Hib (H. influenzae type B vaccine) |
| What is Reye syndrome? | Acute encephalopathy with fatty degeneration resulting in marked cerebral edema and enlargement of the liver with marked fatty infiltration. |
| Why are children not given aspirin for viral infections? | salicylates have been linked to Reye syndrome. |
| What are some s/s of Reye syndrome? | vomiting usually w/o diarrhea after viral illness, change in LOC, elevated liver enzymes w/o jaundice |
| What are teachings to prevent Reye syndrome? | teach parents to avoid giving salicylates for pain or fever in kids, and they should read OTC meds label for salicylates |
| What is cerebral palsy (CP)? | nonprogressive impairment of motor fx control; manifests differently in each child |
| What causes CP? | brain injuries or anoxia in utero or during delivery |
| What are warning signs of cerebral palsy in a 3 mo old child? | poor head control, no smiling |
| Why do all children with myelomeningocele have bowel and bladder problem? | d/t decreased innervation in sacral area of cord |
| Neural tube defect has been linked to lack of what nutrient in maternal diet? | folic acid --> recommend 400 mcg folic acid for women of childbearing age |
| What test is done in antenatal period to screen for neural tube defect? | amniocentesis for increased AFP levels |
| What is hydrocephalus? | normal circulation of spinal fluid is interrupted --> pressure on the brain, deformity, and progressive enlargement of head. |
| What is treatment for hydrocephalus? | VP shunt |
| What are nursing interventions for an infant with myelomeningocele? | - protect defect with a clear sterile dressing - avoid pressure to area - observe for hydrocephalus - observe infant's ability to move extremities |
| What is epilepsy? | a series of seizures that result from focal or diffuse discharges in cortical neurons |
| What are safety precautions for a pt admitted for epilepsy? | bed in low position, O2 and suction equipment ready |
| What should RN do after a child's seizure has stopped? | note time, assess airway, suction PRN, position pt on side, apply O2, VS, asses for injuries, stay with pt, ensure MD notified, administer meds as Rx |
| A single seizure lasting <10 min or a series of seizures lasting 20-30 is called what? | status epilepticus |
| What are types of head injuries? | concussion, closed injury, fractures, intracranial hematoma |
| The Glascow Coma Scale assesses what 3 kinds of response? | - best eye response - best verbal response - best motor response |
| What is strabismus? | eye misalignment, inability to focus on a single object --> 2x vision (normal up to 6 mo of age) |
| If left untreated what can otitis media lead to? | conductive hearing loss |
Created by:
odbal24
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