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Nur-425
Exam #4 - CNS Disturbance
| Term | Definition |
|---|---|
| Name the two most common types of neural tube defects | Anencephaly and spina bifida |
| What is a neural tube defect? | A defect where the neural tube does not close normally |
| What is the treatment for anencephaly? | No treatment; it is contraindicative to life |
| What is spina bifida occulta? | Spinal column is not closed all the way but there is no protrusion |
| What is spina bifida cystica? | The spinal cord is not closed all the way and a sac is protruding |
| What is meningocele? | Less severe form of spina bifida cystica where the protruding sac contains meninges and spinal fluid |
| What is myelomeningocele? | More severe form of spina bifida cystica where the protruding sac contains meninges, spinal fluid and nerves |
| What vitamin deficiency has been implicated in the development of spina bifida? | Folic acid |
| How much folic acid is normally contained in a multivitamin? | 0.4 mg |
| How much folic acid should a woman take who has a history of a previous NTD? | 4 mg daily beginning one month prior to conception |
| What prenatal test can be used to identify NTD? | Alpha-feta protein testing of maternal blood |
| At what gestational period would the AFP test be done? | 16-18 weeks gestation |
| Where are the majority of myelomeningoceles located? | In the lumbosacral area |
| What other condition is experienced by 90% of infants with myelomeningoceles? | Hydrocephalus |
| When is the preferred surgery time period for treatment of myelomeningoceles? | Between 12 and 72 hours to prevent infection/trauma |
| There is a high correlation between an allergy to this product and the diagnosis of NTD | Latex |
| What position should an infant be laying in who has a myelomeningoceles? | Prone |
| Preoperatively, how is the myelomeningoceles cared for? | Keep sac moist with normal saline dressings and change q 2-4 hours |
| Postoperatively, how should the infant be positioned who had a myelomeningoceles? | Prone or side-lying and held upright |
| What complications are associated with a myelomeningoceles? | Urinary/bowel dysfunction |
| What procedure is used in the maintenance of urinary dysfunction in a child with myelomeningoceles? | Clean intermittent catheterization |
| What medications are used to treat urinary dysfunction in a child with myelomeningoceles? | Ditropan and Detral are used to treat overactive bladder |
| What is defined as the imbalance of production and absorption of cerebrospinal fluid? | Hydrocephalus |
| Name two reasons for the accumulation of CSF in the brain | Too much production of CSF and blockage of drainage of CSF (NTD) |
| Name two signs of hydrocephalus | Enlarged head circumference (95th percentile) and signs of increased intracranial pressure (ICP) |
| What can be used to drain the CSF fluid that builds-up in the head (hydrocephalus)? | Ventricular peritoneal shunt |
| After placement of a ventricular peritoneal shunt, in what position should the child be placed? | On the nonoperative side to monitor site; flat in bed |
| Name several signs of possible shunt malfunction in the treatment of hydrocephalus | Widening sutures, fever, malaise and irritability |
| This is a chronic disorder characterized by recurrent unprovoked seizures | Epilepsy |
| This type of partial seizure involves no loss of consciousness, motor activity symptoms on one side of the body, and sensory symptoms of a seizure like flashing light or buzzing sounds | Simple (focal) seizure |
| This type of partial seizure is characterized by automatisms such as smacking the lips and repeating words over and over again | Complex partial (psychomotor) |
| Name the four types of generalized seizures | Tonic-clonic (grand mal), absence (petit mal), atonic (drop attacks) and myoclonic |
| What are some characteristics of a tonic-clonic seizure? | Intense muscular contractions, patient may be cyanotic or incontinent, confused afterwards |
| What are some characteristics of an absence seizure? | Very subtle, brief loss of consciousness that resembles day dreaming, onset is 4-12 years of age |
| What are some characteristics of an atonic seizure? | Sudden momentary loss of muscle tone, may or may not lose consciousness, onset is 2-5 years |
| What are some characteristics of myoclonic seizures? | Involves one extremity and that body part contracts, noticed as child goes in and out of wakeful state, mostly in school age and adolescent kids |
| Name two unclassified epileptic seizures | Infantile spasms and Lennox-Gestaut syndrome |
| What are some characteristics of infantile spasm seizures? | Rare; affects infants 6-8 months; symmetric muscle contraction; most have severe developmental delay associated with a cerebral anomaly; poor prognosis |
| What are some characteristics of Lennox-Gestaut syndrome? | Mixed seizure type; might start out as infantile spasm; accompanied with severe developmental delay; onset is 1-10 years |
| In regards to seizures, what is the purpose of doing laboratory studies? | To rule-out infection and metabolic disturbances |
| What is the most useful diagnostic tool in diagnosing seizures? | EEG; specific seizures elicit specific EEG patterns |
| This diet, used in the treatment of seizures, involves high fat, low carbs or moderate protein intake | Ketogenic Diet |
| This type of therapy is the mainstay in the treatment/management of seizures | Drug therapy |
| This antiepileptic medication can cause allergic rashes, nausea, diplopia, blurry vision and drowsiness | Carbamazepine (Tegretol) |
| This antiseizure medication can cause rashes, sedation, nystagmus and ataxia | Phenytoin (Dilantin) |
| This barbiturate is used for sedation purposes in the treatment of seizures | Phenobarbital |
| This medication used to treat seizures can cause thrombocytopenia and negatively affect the liver | Valproic acid (Depakote) |
| Folic acid and vitamin D supplements are needed when taking these two medications used in the treatment of seizures | Phenytoin (Dilantin) and Phenobarbital |
| This type of seizure is one that continues for 30 minutes or more and does not respond to treatment | Status epilepticus |
| When treating status epilepticus, what is the priority intervention? | CAB - circulation, airway, breathing |
| Besides CAB, what is another essential intervention in the treatment of status epilepticus? | IV access until the IV antiepileptics can be administered |
| What medications might be given to someone experiencing status epilepticus before the IV antiepileptics are started? | Diazepam (Valium) of Lorazepam (Ativan) |
| True or False. When someone is undergoing a seizure, the tongue should be prevented from obstructing the airway by putting something in the person's mouth | False; nothing should be placed in the mouth; ensure a clear airway by placing the person on their side |
Created by:
ssbourbon
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