Nuerosensory and musculoskeletal disorder
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| What is meningitis? | inflammation of the meninges - protective membranes of the brain and spinal cord.
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| Which are the type of meningitis? | - viral: most common, resolves w/out treatment
- bacterial: contagious, high mortality rate
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| What are risk factors for viral meningitis? | viral illnesses
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| What are risk factors for bacterial meningitis? | Upper bacterial resp infections, immunosuppression, injuries that provide direct CSF access, overcrowding
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| What are s/s of meningitis? | HA, N/V, fever and chills, photophobia, nuchal rigidity, +Bruzinski and Kernig's signs, seizures
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| What is the most definitive diagnostic procedure for meningitis? | CSF analysis
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| What are nursing interventions to lumbar puncture for CSF? | NPO 6-8hr, child empties bladder, in fetal position, sedate PRN, clean skin and apply EMLA, take CSF pressure reading
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| How long should child remain in bed in a flat position to prevent leakage that can result in spinal headache? | 4-8 hr
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| What are CSF findings indicative of meningitis? | - cloudy CSF = bacterial, clear CSF = viral
- decreased glucose = bacterial
- elevated WBC, protein, CSF pressure
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| What are nursing interventions for meningitis? | isolate pt, frequent VS and neuro status, initiate IV fluids, maintain safety, administer Rx meds, decrease environmental stimuli
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| What is major concern of meningitis? | increased ICP (preventions: positioning, avoidance of coughing and straining).
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| What vaccines protect infants from bacterial meningitis? | - PCV (pneumococcal vaccine)
- Hib (H. influenzae type B vaccine)
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| What is Reye syndrome? | Acute encephalopathy with fatty degeneration resulting in marked cerebral edema and enlargement of the liver with marked fatty infiltration.
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| Why are children not given aspirin for viral infections? | salicylates have been linked to Reye syndrome.
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| What are some s/s of Reye syndrome? | vomiting usually w/o diarrhea after viral illness, change in LOC, elevated liver enzymes w/o jaundice
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| What are teachings to prevent Reye syndrome? | teach parents to avoid giving salicylates for pain or fever in kids, and they should read OTC meds label for salicylates
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| What is cerebral palsy (CP)? | nonprogressive impairment of motor fx control; manifests differently in each child
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| What causes CP? | brain injuries or anoxia in utero or during delivery
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| What are warning signs of cerebral palsy in a 3 mo old child? | poor head control, no smiling
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| Why do all children with myelomeningocele have bowel and bladder problem? | d/t decreased innervation in sacral area of cord
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| Neural tube defect has been linked to lack of what nutrient in maternal diet? | folic acid --> recommend 400 mcg folic acid for women of childbearing age
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| What test is done in antenatal period to screen for neural tube defect? | amniocentesis for increased AFP levels
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| What is hydrocephalus? | normal circulation of spinal fluid is interrupted --> pressure on the brain, deformity, and progressive enlargement of head.
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| What is treatment for hydrocephalus? | VP shunt
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| What are nursing interventions for an infant with myelomeningocele? | - protect defect with a clear sterile dressing
- avoid pressure to area
- observe for hydrocephalus
- observe infant's ability to move extremities
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| What is epilepsy? | a series of seizures that result from focal or diffuse discharges in cortical neurons
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| What are safety precautions for a pt admitted for epilepsy? | bed in low position, O2 and suction equipment ready
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| What should RN do after a child's seizure has stopped? | note time, assess airway, suction PRN, position pt on side, apply O2, VS, asses for injuries, stay with pt, ensure MD notified, administer meds as Rx
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| A single seizure lasting <10 min or a series of seizures lasting 20-30 is called what? | status epilepticus
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| What are types of head injuries? | concussion, closed injury, fractures, intracranial hematoma
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| The Glascow Coma Scale assesses what 3 kinds of response? | - best eye response
- best verbal response
- best motor response
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| What is strabismus? | eye misalignment, inability to focus on a single object --> 2x vision
(normal up to 6 mo of age)
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| If left untreated what can otitis media lead to? | conductive hearing loss
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Created by:
odbal24
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