The Child with a sensory or neurological condition
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
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| 2 Main functions of the ear | Hearing and balance
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| 3 Divisions of the ear | External ear, middle ear, and the inner ear
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| The eustachian tube infants is ____, _____, and ____ than in older children and adults. (Contribute to infections) | Shorter, wider, straighter
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| In newborns and young infants, why are the walls of the ear canal pliable | because of underdeveloped cartilage and bony structures
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| Infants' eyes may occasionally cross until about ___ weeks of life | Six
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| Tears are scant or absent for first ____ to ___ weeks of life | 2 to 4
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| 3 functions of eustachian tube | 1. Ventilation of middle ear
2. Protection from nasopharyngeal secretions and sound pressure
3. Drainage
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| When are middle ear infections most common | Early childhood
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| 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
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| What may low-set ears be associated with? | Kidney disorders and mental retardation
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| What do you examine the inner ear with? | An otoscope
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| 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
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| How would you instill ear drops in infants? | Gently pull the pinna of the ear DOWN and BACK
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| How would you instill ear drops in children? | Gently pull the auricle of the ear UP and BACK
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| What is an acute infection of the external ear called? | Otitis externa; often referred to as "swimmer's ear"
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| How would you treat Otitis externa? | Irrigation or topical antibiotics
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| What is an inflammation of the MIDDLE EAR? | Otitis media
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| When would Otitis media most often occur? | After an upper respiratory tract infection. (usually between 6 and 24 months)
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| What organisms cause Otitis media? | Streptococcus pneumoniae and Haemophilus influenzae
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| What vaccine can reduce the incidence of pneumococcal otitis media? | Polyvalent pneumococcal polysaccharide (NOT effective in children under 2 years of age)
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| 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
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| What can contribute to respiratory infections in children? | Secondary smoke and Day cares
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| 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
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| What are symptoms of Otitis media? | Severe pain, irritability, diminished hearing, fever, headache, vomiting, diarrhea, and febrile seizures
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| If a child has Otitis media, what will the visulization of the tympanic membrane via otoscope? | A reddened and bulging membrane
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| What can chronic Otitis media lead to? | Cholesteatoma (a cystlike sac filled with keratin debris)
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| How would you treat Otitis media? | A throat culture; antibiotics, analgesics
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| TRUE or FALSE. Antihistamines and decongestants are effective in treating acute Otitis media? | FALSE
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| 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
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| 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
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| TRUE or FALSE. Inserting cotton swabs in to the ears is advised | FALSE
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| When is the inner ear fully formed? | During the early months of prenatal life
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| If an expectant mother contracts German measles or other viral infection, what can the child be born with? | Hearing loss
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| What infectious diseases can result in various degrees of hearing loss? | Measles, Mumps, Chickenpox, or Meningitis
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| 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
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| What records brain wave responses generated by the auditory system? | The brainstem auditory evoked response (BAER) test
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| What instrument measures ear pressure? | Tympanometry
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| What is used to evaluate the infant's orientation response to the sound of a voice? | The Brazelton Neonatal Behavioral Assessment Scale
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| What can the persistence of the Moro reflex beyond 4 months of age indicate? | Deafness
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| 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
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| What are important nursing responsiblities when caring for children with hearing aids? | TEACHING safe battery handling and storage and promoting self-care.
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| What occurs when there is a change in the atmospheric pressure between the internal body systems and the surrounding environment? | Barotrauma
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| During airplane descent, what should children be encouraged to do to promote swalling? | Yawn or chew gum
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| How would you promote swalling in infants? | Bottle-feeding with juice or water
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| What is the visual acuity in a newborn? | 20/400
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| At what age can infants move their eyes to follow people or objects? | 2 to 4 months of age
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| When should coordination of eye movements be achieved? | 3 to 6 months
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| 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
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| What occurs when large epicanthal folds are present? | Chromosomal anomalies
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| A reduction in or loss of vision that usually occurs in children who strongly favor one eye | Amblyopia (lazy eye)
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| What is the most common amblyopia? | Strabismus (cross-eye)
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| What is hyperopia? | Farsightedness
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| What is myopia? | Nearsightedness
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| 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
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| Types of strabismus | Nonparalytic strabismus (concomitant)-one eye is crossed.
Paralytic strabismus- Double vision
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| To prevent double vision (diplopia) the child should do what? | Tilt head or squint when focusing on an object
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| Symptoms of strabismus | eye squinting, covering one eye to see, tilting head to see, dizziness and/or headache
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| An acute conjunctivitis | Ophthalmia neonatorum
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| What is allergic conjunctivitis often associated with? | Allergic rhinitis in children with hay fever
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| Symptoms of conjunctivitis | Itching, tearing, edema
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| The presence of blood in the anterior chamber of the eye; MOST COMMON OCULAR INJURY | Hyphema
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| Where is hyphema found? | bright or dark red spot in front of the lower portion of the iris
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| 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
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| Reye's syndrome affects | Liver and brain
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| What does liver cell pathology cause? | An accumulation of ammonia in the blood
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| Results in neurological changes such as altered behavior, altered level of consciousness, seizures, and coma | Increased intracranial pressure (ICP)
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| Treatment for Reye's syndrome | Reducing ICP and maintaining a patent airway, cerebral oxygenation, and fluid and electrolyte balance
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| The systemic response to infection with bacteria | Sepsis
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| Results of untreated sepsis | Septic shock, multiorgan dysfunction syndrome and death
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| Manifestations of Sepsis | fever, chills, tachypnea, tachycardia, and neurological signs such as lethargy
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| Neutrophil count below 1000/mm3 | Neutropenia
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| Involuntary arching of the back caused by muscle contractions | Opisthotonos
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| Causes of Seizures in Children | Intracranial-Epilepsy, Congenital anomaly, birth injury, infection, trauma, degenerative diseases, vascular disorder
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| Causes of Seizures in Children | Extracranial-Fever, heart disease, metabolic disorders, hypocalcemia, hypoglycemia, dehydration and malnutrition
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| Causes of Seizures in Children | Toxic-Anesthetics, Drugs, Poisons
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| Types of Cerebral Palsy | Spastic, Athetoid, Ataxic, and Mixed
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