Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Peds Neuro
Neurologic D/O
| Question | Answer |
|---|---|
| Menigitis definition | Inflamm of meningnes, viral or bacterial. Bacterial more dangerous |
| Meningitis risk factors | Viral illnesses, URI (otitis media, tonsillitis), immunosuppression, injuries (penetrate head wound and skull fracture), overcrowded living sit |
| Meningitis s/sx (newborns) | Poor muscle tone, weak cry, poor feeding, fever/hypothermia, no illness at irth but progresses within few days |
| Meningitis s/sx (2mo-2yrs) | Seizures c. high-pitched cry, fever and irritabilty, bulging fontanels, nuchal rigidity, poor feeding, vomiting |
| Meningitis s/sx (2 yrs-teen) | Seizures (initial sign), nuchal rigidity, + Brudzinski sx (Flexion of ext c. deliberate flex of neck), Kernig's sx (resist extension of leg from flexed position), fever, chills, HA, petechia/rash, chronic ear drainage |
| Meningitis other sx | Photophobia, progressive drowsiness, delirium, stupor, coma (may initially be irritable and restless) |
| Meningitis lab tests | Blood C&S to ID broad-spec antibiotic. CBC, CSF collection (elevated WBC, protein, decreased glucose, increased CSF pressure, cloudy CSF -bac, clear if viral) |
| Meningitis Dx procedures | CF analysis: best test. Collect c. lumbar puncture. |
| Lumbar puncture considerations | Empty bladder first. Place in fetal position if young, older kids can be sitting. Admin sedatives as Px. Apply local anesthetic, monitor site for hematoma/infxn. |
| T or F: with Meningitis start antibiotics stat and later adjust for specific microbe | T |
| Dexamethasone can be used for _____ | Initial reduction if increased ICP and herniation |
| Meningitis pt. education | Encourage remain in bed for 4-8hr in flat position to prevent leakage and spinal HA. CT scan or MRI to detect increased ICP or abscess |
| The presence of petechia or purpuric rash for Meningitis pt. requires | Immediate medical attention |
| T or F: pt. c. Meningitis on standard precautions | F. On droplet |
| How long pt. on isolation for Meningitis/ | Continue for 24h after first antibiotic given |
| Other RN considerations for Meningitis | NPO status if pt. decreased LOC (advance to clear->diet pt. toelrates when improved LOC). Decrease environ stimuli, minimize exposure to bright light, keep room cool, position w/o pillow and slightly elevate HOB. Seizure precautions. |
| How to reduce incidence of Meningitis | Hop and pneumococcal vaccines |
| Meningitis complications | 10-15% bacterial fatal; encephalitis, meningoccemia, may have lifetime neuro deficit. |
| Head trauma: 3 major causes in order of importance | Falls, MV injuries, bicycle injuries |
| Majority of deaths from falls at what age? Majority of bike accidents? | Falls: 0-4 yrs. Bicycle: 5-19 yrs |
| Head trauma s/sx | Altered mental status w/ or w/o loss of consciousness. Skull fracture, shaering or tissue, and prolonged effects. |
| Head trauma signs of increased ICP | Severe HA, deteriorating LOC, restlessness, irritability, agitation; dilated/fixed or constrcited/fixed, slow to react, or nonreactive pupils, altered breathing (deep fast, intermittent gasping), abnormal posturing |
| Decorticate | Arms, wrists, fingers flexed and bent inward onto chest. Legs extended and abducted. Dysfunction of cerebral cortex |
| Decerebrate | Backward arching of head and arms c. legs rigidly extended and toes downward. Dysfunction c. midbrain |
| Cushing's reflex | Late sign of head trauma, s/sx: severe HTN c. widening pulse pressure, bradycardia, irregular resp |
| GCS of 0-8 | Severe head injury and coma |
| GCS of 9-12 | Moderate head injury |
| GCS of 13+ | Minor head trauma |
| Head trauma lab tests | ABGs, ETOH/drug screen, CBC c. differential |
| Head trauma Dx procedure | Cervical spine films (r/o spine injury), CT or MRI of head, ICP (expected 10-15 mmHg) |
| Head trauma complications: | Risk of epidural/subdural hematoma, herniation, infxn, edema, Cushing triad, coma |
| Head trauma care: | Stabilize spine, neuro Ax, mecha vent if needed, give O2 so sat >95%, hyperventilate to keep PaCO2 30-35 mmHg, HOB @ 30, minimize endotrach/PO suction, avoid cough/straining |
| Head trauma care environ: | Calm, restful environ, conserve energy, restrain ext to prevent pulling tubes, turn q2h |
| Concussion will have immediate or delayed | HA, fatigue, vomiting, seizures. All need to be reported |
| T or F: subtle behavioral changes noticable day of concussion | T |
| Hallmarks of concussion: | Confusion, amnesia (usu immediately after concussion) |
| WA state law re: concussion | If pt. return to play before brain heals original concussion, may get 2nd concussion syndrome. Need written approval from MD trained in concussion Tx/eval before returning to sports |
| Post concussion syndrome | Sequela to brain injury: HA, dizziness, fatigue, irritability, anxiety, insomnia, loss of concentration, memory impariment. Typically develop within days and resolve in 3 mo. |
| Clinical sx of post concussion syndrome | Loss of consciousness, posttraumatic amnesia, disorientation or other mental status change |
| Posttraumatic seizures occur in... | Children who survive head injury, more common in younger than ppl > 16yrs |
| Anoxic brain injury definition | Decreased neuro function r/t birth injury or submersion trauma |
| 40% of submersion injuries occur in children of what age/ | Younger than 5 years. Top-heavy toddlers esp. |
| Anoxic brain injury, primary problem is | Hypoxia d/t global cell damage. Others include aspiration and hypothermia |
| Anoxia of less than ___ has good prognosis | Less than 5 min |
| All children c. submersion injury should be hospitalized ____ for observation | 12-48h d/t respiratory compromise or cerebral edema showing later |
Created by:
choel
Popular Nursing sets