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N114 Neuro

N114 - Neuromuscular & Cerebral Dysfunction

QuestionAnswer
Cerebral Palsy Non-progressive motor dysfunction, a loss or deficiency of motor control with involuntary spasms caused by permanent brain damage present at birth
Cerebral Palsy patho Anoxia (lack of O2) to the brain is main cause
Cerebral palsy signs Missing physical developmental milestones, head control, sitting, stiff or rigid extremities, floppy body posture
Hypotonia Floppiness - increased ROM of joints
Hypertonia Rigity - extremely tight muscles, spastic, stiff movements, scissoring of lower extremities
Athestosis Constant involuntary writhing motions
Ataxia High-stepping gait, stumbling, lurching, nystagmus - constant eye movement
Diplegia Involves both arms or legs, lower dysfunction is greater than upper function
Hemipelgia One side of the body, upper extremities more dysfunctional than lower, One side of the body, upper extremities more dysfunctional than lower
Quadriplegia All four extremities with equal involvement
Cerebral palsy treatment PT/OT, casting, braces & splints, drug therapy - antianxiety agents, anticonvulsants, muscle relaxants
Cerebral palsy surgical treatment 1 Selective posterior rhizomoty - incision into spinal cord for pain relief & muscle spasm
Cerebral palsy surgical treatment 2 Soft tissue lengthenings - release of hamstrings
Spina bifida Neural tube defect
Spina bifida occulta Spinal cord intact, dimple may be present - no neurologic defects
Meningocele Protrusion involves meninges & sac-like cyst. Contains CSF
Myelomenigocele Same as menigocele but contains spinal cord
Spina bifida causes Failure of neural tube to close (4th week), lack of folic acid
Spina bifida signs/symptoms Hydrocephalus, paralyzed lower extremities, bowl & bladder dysfunction, kyphosis, scoliosis, contractures
Spina bifida diagnosis Prenatal diagnosis, elevated AFP, chorionic villi sampling
Spina bifida treatment Surgery within 24-72 hrs
Spina bifida ortho problems May require urinary catheterization, shunt for hydrocephalus, latex allergy
Febrile seizures Occur at low fever 101, 107 = brain damage
Fever assessments Lowest temp occurs 2-4 am, highest occurs 6-10 pm, neonate may be hypothermic w/sepsis
Fever management Antipyretic, Increase fluid intake. No Aspirin, No Alcohol sponge baths, No immersion in cool bath
Reye's Syndrome Toxic encephalopathy, characterized by fever, impaired consciousness, hepatic dysfunction
Reye's syndrome causes Follows a common viral illness, association between aspirin administration
Reye's syndrome signs/symptoms Increased free fatty acid level, Hyperammonemia, impaired liver function, significant brain swelling
Reye's syndrome management Early diagnosis & aggressive therapy. Rapid progression through coma stage w/high peak ammonia
Reye's syndrome nursing Intensive nursing care, Neomycin given through NG to decrease ammonia
Meningitis Infectious disease characterized by inflammation of the meninges usually caused by a bacterial infection
Meningitis causes Bacteria, viral, or fungal infection.
Meningitis patho Pathogen acts as a toxin, releases purulent exudate. Necrosis of brain cells can cause permanent damage & death
Meningitis signs/symptoms Severe symptoms - headache, stiff neck, photophobia, malaise & irritability
Kernig's sign Contraction or pain in the hamstring
Opisthotonos Head and heels bent backward and body arched forward
Brudzinski's sign An involuntary flexion of the hip and knee when the neck is passively flexed
Created by: jrb265
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