07 Neurological / Cognitive Disorder Flashcards
What is often a first sign of increased ICP (Intracranial Pressure)?
Level of Consciousness
What does the pediatric glasgow coma scale assess for?
Eyes
Motor Response
Verbal Response
Score of 15 is unaltered LOC
Score of 3 is extremely decreased LOC
What are some late signs of Cushing’s Triad/Refelx? (3)
Increased Systolic BP, widened pulse pressure
Bradycardia
Irregular Respirations
What is the leading cause of injuries and death i nchildren?
Motor vehicles.
Motor behicles, falls and bike injuries are the 3 major causes for brain injury in children
What are primary head injuries that may occur at the time of trauma? (4)
- Concussion/Contusions
- Skull Fracture
- Intracranial Hematoma
- Diffuse Injury
What are subsequent complications of head injuries? (4)
- Hypoxic brain injury
- Increase ICP
- Infection
- Cerebral edema
What is the most common head injury? What does it result from?
The most common head injury is concussion and results from trauma to the head.
Generally followed by amnesia and confusion.
What is Second Impact Syndrome?
- Second injury before brain has time to heal
- Rapid and severe, life threatening swelling can occur
- Typically occurs when there’s concussion and brain gets injuried before it has time to heal
The terms contusion and laceration are used to describe what?
visible bruising and tearing of cerebral tissue
Coup describes
bruising at point of impact
Contrecoup describes
bruising at site far removed from point of impact. Occurs in kids with big heads.
What may cause hemorrhage with hypovolemic hypotension i older children?
Fracture on the underside of the skull that can tear the meningeal artery
What exactly is meningitis?
Inflammation of meninges
What are some differences between viral and bacterial meningitis?
Bacterial appearance is cloudy vs Viral’s Clear
Bacterial has increased protein, and decreased glucose, wehreas Viral levels are within the norm.
The bacterial meningitis is more dangerous than viral as well and may cause developmental complications
What kind of bacterial agents causes meningitis?
- meningococci
- strep pneumococci
- haemophilius
What is the primary source of bacterial meningitis infections?
Ear infections.
There’s drop infection from naspharyngeal secretions.
What’s the main sign of meningitis?
Petechial or purpuric rash
What are 3 main nursing interventions for meningitis? (3)
- universal and droplet infection control measures
- IV antibiotics
- Decrease environmental stimulation
what is the most serious complication of meningitis?
Shock may occur resulting in peripheral circulatory collapse
What are 3 main symptoms that occur with viral meningitis?
- headache, irritability, nuchal rigidity
- Low grade fever
- Photophobia
What is Reye Syndrome?
Toxic encephalopathy associated with hepatic organ involvement
Reyes syndrome typically follows viral illness and is associated with the use of what meds?
associated with use of ASA
What is plagiocephaly and what is it believed to be caused by?
Skul is progressively flattened and believed dto be caused by supine positioning.
What is craniosynostosis?
Premature closure of single/multiple sutures of cranial vault, face and base of skull
May lead to increased ICP and brain damange
Management is surgical release of closed sutures.
What is hydrocephalus?
Hydrocephalus is a symptom of an imbalance in the production and
absorption of cerebrospinal fluid in the ventricular system. Spinal
fluid accumulates resulting in compression of the brain against
surrounding rigid bony cranium and enlargement of the skull.
What are treatments for hydrocephalus?
Mechanical shunting
}Shunt placed in lateral ventricle & drains into internal jugular vein or peritoneum.
}Shunts need to be revised as child grows and length of tube needs to be increased (common reason for revision). Shunts are also prone to malfunctioning and may require revisions.
