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Peds-Neuro Condition

The Child with a sensory or neurological condition

QuestionAnswer
2 Main functions of the ear Hearing and balance
3 Divisions of the ear External ear, middle ear, and the inner ear
The eustachian tube infants is ____, _____, and ____ than in older children and adults. (Contribute to infections) Shorter, wider, straighter
In newborns and young infants, why are the walls of the ear canal pliable because of underdeveloped cartilage and bony structures
Infants' eyes may occasionally cross until about ___ weeks of life Six
Tears are scant or absent for first ____ to ___ weeks of life 2 to 4
3 functions of eustachian tube 1. Ventilation of middle ear 2. Protection from nasopharyngeal secretions and sound pressure 3. Drainage
When are middle ear infections most common Early childhood
How would a nurse examine the ear? Observe both the exterior and the interior. Observe alignment. The top of the ear should cross an imaginary line drawn from the outer canthus of the eye to the occiput
What may low-set ears be associated with? Kidney disorders and mental retardation
What do you examine the inner ear with? An otoscope
What method of restraint is used when assisting the exam of the inner ear? Lay the child on a table with the arms held alongside the head, which is turned to the side OR place the child in the lap of the adult
How would you instill ear drops in infants? Gently pull the pinna of the ear DOWN and BACK
How would you instill ear drops in children? Gently pull the auricle of the ear UP and BACK
What is an acute infection of the external ear called? Otitis externa; often referred to as "swimmer's ear"
How would you treat Otitis externa? Irrigation or topical antibiotics
What is an inflammation of the MIDDLE EAR? Otitis media
When would Otitis media most often occur? After an upper respiratory tract infection. (usually between 6 and 24 months)
What organisms cause Otitis media? Streptococcus pneumoniae and Haemophilus influenzae
What vaccine can reduce the incidence of pneumococcal otitis media? Polyvalent pneumococcal polysaccharide (NOT effective in children under 2 years of age)
True or False. Can the pooling of fluids such as milk in the throat of an infant who falls asleep with a bottle of milk provide a source for growth of organisms? TRUE
What can contribute to respiratory infections in children? Secondary smoke and Day cares
What are signs and symptoms of EAR INFECTION? Rubbing or pulling at the ear, Rolling the head from side to side, Hearing loss, Loud speech, Inattentive behavior, Articulation problems, Speech development problems
What are symptoms of Otitis media? Severe pain, irritability, diminished hearing, fever, headache, vomiting, diarrhea, and febrile seizures
If a child has Otitis media, what will the visulization of the tympanic membrane via otoscope? A reddened and bulging membrane
What can chronic Otitis media lead to? Cholesteatoma (a cystlike sac filled with keratin debris)
How would you treat Otitis media? A throat culture; antibiotics, analgesics
TRUE or FALSE. Antihistamines and decongestants are effective in treating acute Otitis media? FALSE
If medical treatment is unsuccessful in treating Otitis media, the physician may incise the tympanic membrane to relieve pressure. what is this surgery called? Myringotomy
A tympanic membrane button or tympanostomy ventilating tube may be inserted when treating Otitis media. When can this spontaneously fall out? Within 6 to 12 months
TRUE or FALSE. Inserting cotton swabs in to the ears is advised FALSE
When is the inner ear fully formed? During the early months of prenatal life
If an expectant mother contracts German measles or other viral infection, what can the child be born with? Hearing loss
What infectious diseases can result in various degrees of hearing loss? Measles, Mumps, Chickenpox, or Meningitis
How should a nurse address a hearing-impaired child? Be at eye level with the child; Be face-to-face with the child; Establish eye contact; Talk in short sentences; AVOID using exaggerated lip or face movement
What records brain wave responses generated by the auditory system? The brainstem auditory evoked response (BAER) test
What instrument measures ear pressure? Tympanometry
What is used to evaluate the infant's orientation response to the sound of a voice? The Brazelton Neonatal Behavioral Assessment Scale
What can the persistence of the Moro reflex beyond 4 months of age indicate? Deafness
Where are hearing aids designed to fit? In the ear, Behind the ear, On eyeglass frames, or on the body with wires to the ear
What are important nursing responsiblities when caring for children with hearing aids? TEACHING safe battery handling and storage and promoting self-care.
What occurs when there is a change in the atmospheric pressure between the internal body systems and the surrounding environment? Barotrauma
During airplane descent, what should children be encouraged to do to promote swalling? Yawn or chew gum
How would you promote swalling in infants? Bottle-feeding with juice or water
What is the visual acuity in a newborn? 20/400
At what age can infants move their eyes to follow people or objects? 2 to 4 months of age
When should coordination of eye movements be achieved? 3 to 6 months
What are folds of skin that extend on either side of the bridge of the nose and cover the inner eye canthus called? Epicanthal folds
What occurs when large epicanthal folds are present? Chromosomal anomalies
A reduction in or loss of vision that usually occurs in children who strongly favor one eye Amblyopia (lazy eye)
What is the most common amblyopia? Strabismus (cross-eye)
What is hyperopia? Farsightedness
What is myopia? Nearsightedness
TRUE or FALSE. The weak eye should be patched in treatment? FALSE. The GOOD eye is patched to force the use of the affected eye
Types of strabismus Nonparalytic strabismus (concomitant)-one eye is crossed. Paralytic strabismus- Double vision
To prevent double vision (diplopia) the child should do what? Tilt head or squint when focusing on an object
Symptoms of strabismus eye squinting, covering one eye to see, tilting head to see, dizziness and/or headache
An acute conjunctivitis Ophthalmia neonatorum
What is allergic conjunctivitis often associated with? Allergic rhinitis in children with hay fever
Symptoms of conjunctivitis Itching, tearing, edema
The presence of blood in the anterior chamber of the eye; MOST COMMON OCULAR INJURY Hyphema
Where is hyphema found? bright or dark red spot in front of the lower portion of the iris
Treatment for Hyphema Bed rest and topical medication; elevate head 30 to 45 degrees to decrease intraocular pressure and intracranial pressure if there is a head injury
Reye's syndrome affects Liver and brain
What does liver cell pathology cause? An accumulation of ammonia in the blood
Results in neurological changes such as altered behavior, altered level of consciousness, seizures, and coma Increased intracranial pressure (ICP)
Treatment for Reye's syndrome Reducing ICP and maintaining a patent airway, cerebral oxygenation, and fluid and electrolyte balance
The systemic response to infection with bacteria Sepsis
Results of untreated sepsis Septic shock, multiorgan dysfunction syndrome and death
Manifestations of Sepsis fever, chills, tachypnea, tachycardia, and neurological signs such as lethargy
Neutrophil count below 1000/mm3 Neutropenia
Involuntary arching of the back caused by muscle contractions Opisthotonos
Causes of Seizures in Children Intracranial-Epilepsy, Congenital anomaly, birth injury, infection, trauma, degenerative diseases, vascular disorder
Causes of Seizures in Children Extracranial-Fever, heart disease, metabolic disorders, hypocalcemia, hypoglycemia, dehydration and malnutrition
Causes of Seizures in Children Toxic-Anesthetics, Drugs, Poisons
Types of Cerebral Palsy Spastic, Athetoid, Ataxic, and Mixed
Created by: vandas