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