Alterations in Cognition and Sensation (Peds) Flashcards
autism
Developmental disorder and its onset is in infancy or early childhood. Atypical patterns of development and clusters of developmental problems and deficits. Ranges from mild to severe
Etiology: Genetic makeup, brain abnormalities, altered chemistry, virus, or toxic chemicals
Symptoms: Noticeable between 12 and 36 mos. Indicators: Lack of social ability, lack of verbalization, little interest in verbal interaction/response, inability to use toys, lack of smiling, excessive preoccupation with creating order.
Management: No meds or treatment available, early identification is essential, stimulants for hyperactivity, antipsychotics for repetitive and aggressive behaviors.
Goals: For the child to reach optimal functioning within the limitations of the disorder.
Interventions: Work closely with families to determine the child’s routine, habits, and preferences. Identify specific cues and behaviors, be patient and supportive, and seek alternative communication styles. Autistic children have abnormalities in speech production. Be mindful of safety and to prevent harm.
increased intercranial pressure
A rise in the normal pressure in the skull
Early Signs of Increased ICP: H/A, vomiting (projectile possibly), blurred/double vision, dizziness, Dec. HR & RR, Inc. BP and pluse pressure, pupil reaction time Dec. and unequal, sunset eyes, changes in LOC, irritability, seizure activity. In infant will also see: Bulging fontanels, Inc. head circumference, dilated scalp veins, high-pitched cry.
Late Signs: Lowered LOC, Dec. motor and sensory responses, Dec. HR, irregular respirations, Cheyne-Stokes respirations, decerebrate or decorticate posturing, fixed and dilated pupils
computed tomography
Noninvasive X-ray study that looks at tissue density and structures (sliced images). Used to diagnose tumors, fractures, hemorrhage and congenital abnormalities. Can be used with or without contrast. Check for NPO status and allergies before scan. Unless contraindicated, encourage fluid intake after the procedure
seizures
Epilepsy is a complex disorder if the CNS (brain is affected), disruption in electrical communication among neurons, imbalance between excitatory and inhibitory mechanisms. Numerous causes: Acquired and brain injury, familial and unknown.
3 categories of seizures: Focal, generalized and unknown
Management: Control seizures or reduce frequency and prevent injury, administer meds and treatments (anticonvulsants primary mode of treatment. Surgery if remain uncontrolled. Nonpharmacy treatment is ketogenic diet (high fat, low carb), vagal nerve stimulator
Provide education and support to the child and family. Med compliance, adverse reactions, follow-up care, activity restrictions, refer to support groups.
SEIZURE PRECAUTIONS
Status Epilepticus is a neurologic emergency. Single seizure lasting 5 mins or more or recurrent seizures lasting more than 5 mins with no return to normal LOC
Management: Prompt medical intervention
Treatment: ABC’s, anticonvulsants, benzos (lorazepam and diazepam, and fosphenytoin are common meds used)
Febrile seizures
Neonatal seizures
croup
Occur in children between 3 mos. and 3 y/o. Parainfluenza is responsible for a majority of croup cases. URI’s usually precedes. Differentiate between viral croup and bacterial epiglottitis for treatments.
Symptoms: Often begins at night, sudden onset of harsh, metallic, barky cough, Sore throat, inspiratory stridor, hoarseness, use of accesory muscles to breath, frightened appearance and agitation, cyanosis, low grade fever.
Infants and toddlers: Nasal flaring, intercostal chest retractions, continuous stridor, Inc. RR
Meds: Corticosteroids (single dose) and racemic epinephrine aerosols. Usually self-limiting and can be managed at home.
Management: Maintain patent airway, oral hydration if not in respiratory distress and may treat at home for spasmodic croup but other forms of croup treated at hospital. Take child out into cool, humid night air or steamy bathroom (relieve mucosal swelling). Use calm approach because crying aggravates the airway obstruction.
