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Neuro Peds

What age do you do head circumference often. 3 years and under
What is indicated when there is an absence of eye reflexes? Neuro problem
Change in LOC Early indicator of neuro problems
Five stages of consciousness Full consciousness, confusion, obtunded, stupor, coma
Full consciousness The child is awake and alert; is oriented to time, place, and person; and exhibits age appropriate behaviors
Confusion Disorientation exists; the child may be alert but responds inappropriately to questions
Obtunded The child has limited responses to the environment and falls asleep unless stimulation is provided
Stupor The child only responds to vigorous stimulation
Coma The child can not be aroused, even with painful stimuli
Glasgow Coma Scale Score The lower the score the less responsive the child is.
Widened pulse pressure indicates what? Increase intracranial pressure
Early signs of increased ICP Headache, vomiting, blurred vision, diplopia, dizziness, decreased pulse and respiration, increased blood pressure and pulse pressure, pupil reaction time decreased and unequal, sunset eyes, changes in LOC (irritability), seizure activity
Late signs of increased ICP Lowered LOC, decreased motor and sensory responses, bradycardia, irregular repirations, Cheyney Stokes respiration, decerebrate or decorticate posturing, fixed and dilated pupils
Positive Macewen sign (cracked pot) Can indicate separation of sutures
Diazapam Used to treat status epilecticus; does not like to be mixed well with anything
Phenotonin Can cause gingiva dysplasia (hyperplasia), use a soft tooth brush and nonalcoholic mouth wash
Epilepsy diagnosis Two or more unprovoked seizures more than 24 hours apart
Ketogenic diet High fat, protein, and low carbs; ketosis state, mildly dehydrated, avoid sugary foods, wheat based products, all fruit, beans, lagoons, root veggies, condiments, mayo, alcohol
Postictal state After seizure, very short and child is wore out
What to monitor during a seizure Time started, how long, vital signs, cyanosis, and incontinence
What is a febrile seizure usually associated with? Fever, usually a viral illness
Febrile seizures effect what age group Younger than 5, peak incidence between 14-18 months
When is a febrile seizure rare? Less than 6 months or older than 5 yrs
Who are febrile seizures more common in? Boys
Neonatal seizures caused from what? Underlying hypoxic ischemia encephalopathy, metabolic disorders, and intracranial hemorrhage
When do neonatal seizures normally occur? With in the first 4 weeks of life
Anencephaly Small or missing brain hemisphere, skull, and scalp; no forebrain or cerebral, brain tissue maybe exposed; incompatible with life, reflex actions only
Encephalocele Protrusion of the brain and meninges through a skull defect; possible to have normal intelligence
What causes encephalocele to occur Failure of the anterior portion of neural tube to close
Microcephaly Head circumference more than three standard deviations below the mean for the age and see of the child; congenital or acquired within the first few years of life
Causes of congenital microcephaly Abnormal development during gestation or intrauterine infection, chromosomal abnormalities
Cause of acquired microcephaly Severe malnutrition, perinatal infection, anoxia during early infancy
Arnolds Chiara malformation type I Deformitiy from cerebellar tonsils displacing upper cervical canal; Occurs in adolescence and adulthood, no hyrdrocephalus-more benign form
Arnolds Chiara malformation type I signs and symptoms Headache, lower extremity spasticity, urinary frequency
Arnolds Chiara malformation type II Deformity from cerebellum, the medulla oblongata, and forth ventricle displacing into the cervical canal, which causes obstruction of the CSF and leads to hydrocephalus
Hydrocephalus Impaired absorption or circulation of the CSF
Types and classifications of hydrocephalus Congenital and acquired; obstructive (noncommunicating) and non-obstructive (communicating)
Intracranial arteriovenous malformation abnormal development of blood vessels in brain, brain stem, or spinal cord; hemorrhage can occur and leads to serious neurologic deficits and death
intracranial bleeding bleeding out the nose, ears, and under the eyes
signs and symptoms of intracranial arteriovenious malformation intracranial hemorrhage, seizures, headaches, progressive neurologic deficits, vision problems, loss of speech, problems with memory, and paralysis
Craniosynostosis premature closure of cranial sutures; inhibits brain growth and causes distorted skull appearance
Positional Plagiocephaly asymmetry in head shape without fused sutures
bacterial meningitis infection of the meninges; can lead to brain damage, nerve damage, deafness, stroke, and death; rapid assessment and treatment needed
bacterial meningitis in newborns caused by streptococcus, gram-negative enteric bacilli, and Listeria monocytogenes
bacterial meningitis in children caused by Neisseria meningitidis and Streptococcus pneumoniae
Bacterial meningitis nursing management reducing fever and prevention
Aseptic meningitis most common type for children younger than 1 year of age; usually viral, supportive treatment, self-limiting, 3-10 days
Aseptic meningitis signs and symptoms fever, general malaise, headache, photophobia, poor feeding, nausea, vomiting, irritability, lethargy, neck pain, positive Kernig and Brudzinski signs
Encephalitis inflammation of the brain and may include meninges
What causes encephalitis protozoan, bacterial, fungal, and viral invasion; herpes simplex virus, enteroviruses, arthropodborne viruses
Reye syndrome signs and symptoms severe and continual vomiting, changes in mental status, lethargy, irritability, confusion, hyperrelexia
Reye syndrome Reye syndrome is a disease that primarily affects children younger than 15 years of age who are recovering from a viral illness;Reye syndrome is a reaction that is triggered by the use of salicylates or salicylate-containing products to treat a viral infe
medical treatment for neurologic disorders shunt placement, ventilation, PT/OT/ST, external ventricular drainage, ventricular tap, vagal nerve stimulator, ketogenic diet
signs and symptoms of shunt infection elevated vital signs, poor feeding, vomiting, decreased responsiveness, seizure activity, signs of local inflammation along the shunt tract
acute stroke in children signs and symptoms weakness on one side of hemiplegia, facial droop, slurred speech, and speech deficits
signs and symptoms of spinal cord injury inability to move or feel extremities, numbness, tingling, weakness
Positioning of a child with myelomenigocele prone only, not on the back
muscular dystrophy group of inherited conditions result in progressive muscle weakness and wasting
Muscular dystrophy types mainly skeletal; nine types, Duchenne muscular dystrophy is the most common
Duchenne Muscular Dystrophy mutation-absence of dystrophin; X-linked recessive; rare to survive past early 30s
Spinal muscular dystrophy genetic motor neuron disease; affects spinal nerves ability to communicate with the muscles
Lab tests for Spinal muscular dystrophy creatine kinase (H), genetic testing (SMA gene), muscle biopsy, never conduction velocity and electromyelogram
Cerebral Palsy Cerebral palsy is a term used to describe a range of non-specific clinical symptoms characterized by abnormal motor pattern and postures caused by nonprogressive abnormal brain function; majority of causes occur before delivery
Signs and symptoms of Cerebral Palsy motor impairment including spasticity, muscle weakness, and ataxia
complications of cerebral palsy mental impairment, seizures, growth problems, impaired vision or hearing, abnormal sensation or perception, and hydrocephalus
Guillain-Barre' Syndrome Guillain-Barré syndrome is an uncommon disorder in which an immune response within the body attacks the peripheral nervous system but does not usually affect the brain or spinal cord.
Guillain-Barre' Syndrome signs and symptoms Guillain-Barré syndrome results in inflammation and demyelinization of the peripheral nerves. Physical examination findings may include decreased or absent tendon reflexes. Facial weakness or difficulty swallowing may also be present.
Myasthenia Gravis Autoimmune inherited as a rare genetic disease; progressive weakness and fatigue of skeletal muscles
Dermatomyositis inflammation of the muscles or associated tissues; more frequent in girls between 5 and 14 years of age;
Dermatomyositis effects what? skin, muscles, kidneys, retinas, GI tract
Botulism Botulism is a disease that is caused by a toxin produced in the immature intestines of young children resulting from infection with the bacterium Clostridium botulinum
Signs and symptoms of botulism constipation, poor feeding, listlessness, generalized weakness, and weak cry
True or False At birth, the cranial bones are not fused, leading to an increased risk for hemorrhage False
True or false CT scans and MRIs are useful in the diagnosis of hemorrhages, infections, or obstructions False
True or False Prematurity, difficult delivery, and infection during pregnancy are risk factors associated with neurologic disorders. True
True or False Nursing interventions for a child with hydrocephalus include maintaining cerebral perfusion, administering intravenous antibiotics, and minimizing neurologic complications. False
True or False A family teaching plan for a child with epilepsy should include instructions for responding to seizures for parents, family, teachers, and day care workers. True
Neurological disorders result from__________ problems, infections, or traumas congenitial
________ agents are used in treatment of a confirmed case of aseptic meningitis. Anitviral
Decorticate posturing occurs with damage of the cerebral ______. cortex
A care plan for a child with neonatal seizures will include ensuring adequate __________, correcting any underlying metabolic disturbances, and administering anticonvulsant therapy. Ventilation
The parents of children with chronic neurologic disorders will require large amounts of ________ and support throughout the child's lifetime. education
True or False The hypotonic infant will feel rigid and display an extended trunk and legs. False
True or False Neural tube defects account for the majority of congenital anomalies of the central nervous system. True
True or False Spina bifida occulta often goes undetected. True
True or False Muscular dystrophy is a group of inherited conditions. True
True or False Dermatomyositis occurs more often in girls. True
The newborn infant with myelomeningocele is at increased risk for acquiring meningitis, ______, and hemorrhage. hypoxia
Guillain-Barre' Syndrome results in __________ and demyelinization of the peripheral nerves. inflammation
Cerebral palsy is a disorder caused by abnormal development of, or damage to, the ______ areas of the brain. motor
Spinal muscular atrophy is a genetic motor neuron disease that affects the _____ nerves' ability to communicate with the muscles. spinal
Treatment modalities to promote mobility include___________, pharmacologic management, and surgery. physio-therapy
Created by: mlinger