Alteration in Neuro Function Flashcards by Hannah James

what is significant about infants and their head size

they have small bobble heads

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skull expands until _________

age 2

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sutures are ossified by ______

age 1
(12 months)

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children have greater risk for what kind of spinal injury?

cervical spine
(C1-C2)

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what are some common causes of alteration in mental status in children

infection
trauma
poisoning
seizure
alcohol
substance
DKA

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assessment of neuro status:
-what is signifiant when learning their history?

what is their baseline?

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assessment of neuro status:
-what is the most important indicator of neurological dysfunction

levels of consciousness

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assessment of neuro status:
-what is included in a physical exam?

-alertness/behavior
-LOC
-GCS
-vitals
-skin
-eyes (pupils)
-posture

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decorticate

-flexor posturing
(flexed towards core)

-lesions above brainstem in corticospinal tracts

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decerebrate

-extensor posturing

-lesions of the brainsteam
-can be a sign of herniation
-more concerning

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what is a seizure

abnormal electrical discharges in the brain that cause involuntary movement and behavior

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absent seizure
-s/s

-lip smacking
-twitching
-problems for school age children
-appear to be day dreaming

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absent seizures:
-what is there absence of?

absence of motor involvement

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partial seizure
-s/s

-depends on location
-may have aura

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partial seizure
-where does this occur

-one hemisphere of brain or cerebral cortex

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generalized seizure
-s/s

-spasms are bilateral and symmetric
-consciousness impaired
-rhythmic jerking!! (contraction and extension)

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generalized seizure
-where does this occur

both hemispheres simutaneously

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febrile seizure
-what is the cause

-fever above 101F (38.3C)

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what age group does a febrile seizure usually occur in?

6 months to 5 years old

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febrile seizure
-how long does it last

-usually lasts less than 1 minute but can last up to 15 minutes

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what 5 things should be monitored if a seizure lasts more than 15 minutes

-electrolytes
-glucose
-blood gas
-temperature
-blood pressure

These patients are usually very sick and need a workup

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post ictal

period following seizure
-decreased LOC usually

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most important thing nurses must do when a patient begins seizing

MAINTAIN AIRWAY
-nothing in mouth
-jaw thrust may be helpful

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1st line treatment of a seizure

Benzodiazepine
-lorazepam
-diazepam

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meningitis

inflammation of the meninges covering the brain and spinal cord

causes of meningitis

Viral Bacterial

is bacterial or viral meningitis more serious

bacterial: -can be fatal

S/S of meningitis in young children

-hypothermia -change in feeding pattern -vomiting -diarrhea -bulging or flat ant. fontanelle SAME FOR VIRAL AND BACTERIAL

S/S of meningitis in older children

-febrile -altered LOC -irritabilit -muscle or joint pain

S/S of meningeal irritation

-Headache -Nuchal rigidity (kernigs and brudzinskis)

Kernigs

knee up and resistance or pain when fully extended K=Knee

Burdzinski

knees up and resistance or pain when neck is flexed in

treatment for bacterial meningitis

antibiotics

treatment for viral meningitis

antibiotics -until bacterial meningitis can be rules out

lumbar puncture for bacterial

decreased glucose increased protein

lumbar puncture for viral

normal to high glucose normal to low protein

supportive care for meningitis

-decreased stimulation -pain meds -frequent check of consciousness

nursing considerations: -environmental safety for meningitis

-seizure precautions -fall precautions -isolation

hydrocephalus

imbalance between production and absorption of CSF

hydrocephalus leads to increased ______ volume in brain

CSF (cerebrospinal fluid)

what is non-communicating hydrocephalus

-most common -blockage in ventricular system that prevents CSF from entering subarachnoid space

how do we assess infants for hydrocephalus

measure and compare head circumference

how to children with untreated hydrocephalus appear? why?

increased in head size: -sutures are not approximated, which extends size of head Increased ICP: -sutures are approximated and CSF doesn't have anywhere else to go

what is the main treatment goal for hydrocephalus

reduce ICP prevent CNS dysfunction

treatment for hydrocephalus

-ventricular shunt (ventricular peritoneal- extra CSF goes into belly

common complications from a shunt

Infection -fever -meningitis -abscess Malfunction -coil or kink in shunt -outgrown shunt

S/S of complications with a shunt

-Headache -lethargy -irritability -nonreactive pupils -seizures -change in LOC -fever -sunsetting eyes -high pitch cry -wide sutures -fixed and dilated pupils -increased ICP (if not draining)

complications of shunt: -increased ICP

cushings triad -HTN or widened pulse pressure -bradycardia -irregular respirations

myelodysplasia 1. what is it? 2. who is it more common in?

1. malformation of the spinal cord or spinal canal 2. more girls than boys

why does myelodysplasia occur

due to failed closure of neural tube

spina bifida

defect that occurs in one or more of the vertebrae and allows spinal contents to protrude

spina bifida occulta

-small section of the outer part of vertebrae does not close, leaving an opening in the spinal cord

meningocele

-CSF PROTRUDES INTO SAC -more severe form of spina bifida -outer part of the vertebrae have not completely closed, leaving an opening -sac containing CSF -meninges may be damaged

myelomeningocele

-FLUID AND NERVES -MOST severe form of spina bifida -both meninges and spinal cord itself are pushed out through the opening -can be easily split and expose the contents

nursing management of neural tube defects

-NICU -monitor sac for leakage of CSF -Prone position!!! (dont break sac) -skin care (sac can break down skin) -frequent assessment for infection

why might kids with neural tube defects have latex allergies

multiple surgical procedures -become irritated with latex

spina bifida treatment

surgical repair (usually 24-48 hours)

post op nursing management for spina bifida

-I&Os: at risk for fluid imbalance -PRONE or side lying -keep diaper away from incision site

spina bifida is at increased risk for what?

-infection -neurological injury (due to increased ICP) -ortho injury

what is the most common permanent physical disability in childhood

Cerebral palsy (CP)

Cerebral Palsy (CP)

group of permanent disorders posture characterized by early onset of impaired movement and posture

what is special about CP

it is nonprogressive in nature

what are possible motor signs of CP

-poor head control after 3 months -stiff or rigid limbs -arching back -unable to sit w/o support at 8 months -clenched fist after 3 months -persistant primitive infantile reflexes (startle, tonic neck) -moro beyond 4 months -tonic neck beyond 6 months

what is the main goal for CP

-EARLY RECOGNITION -promotion of optimum development

multidisciplinary care for CP

-eye exams regularly -ortho surgeons -speech therapy -support groups

Alteration in Neuro Function Flashcards

(65 cards)