Alterations in mobility Flashcards
cerebral palsy
Nonprogressive impairment of motor function (muscle control due to extrapyramidal or pyramidal motor system, coordination, and posture), can cause abnormal perception and sensation.
Most common type of movement disturbance is spastic (pyramidal: hypertonicity, Inc. DTR, gross and fine motor impairments, Plegia in one or all four extremities; Dyskinetic (non-spastic, extrapyramidal) Athetoid: involuntary jerky movements , Dystonic: Slow, twisting movements that affects the trunks and extremities with abnormal posturing from muscle contractions. Ataxic: (non-spastic, extrapyramidal): wide based gait with difficulty coordinating, lack of ability to do repetitive movements, lack of coordination with purposeful movements (reaching for something)
Comorbidities: Cognitive, hearing, speech, visual and speech impairments and seizures.
Risk Factors: Existing brain anomalies, cerebral infections, head trauma, anoxia, Maternal chorioamnionitis, maternal infection, premature births, multiple births, very low birth weight, placenta not providing enough O2 and nutrients, interruption of O2 delivery to fetus, direct injury to neonate, maternal drug use or nutritional deficiencies.
Manifestation: Different in each child: Delay in gross motor skills, persistent primitive reflexes (Moro or tonic neck) abnormal muscle tone, developmental milestones not met, abnormal posturing, ataxia, failure of automatic reactions, swallowing impairment.
Medications: Benzos, Antiepileptics, Botulinum toxin A (neurotoxin produced by C. botulinum and relieves spasticity in CP and occasionally torticollis), Baclofen (central-acting skeletal muscle relaxant and Dec. spasticity in CP and spinal cord injury, Baclofen pump also which is surgically implanted).
Treatment: Mainly supportive, preventative, and symptomatic
Nursing Management: Promoting mobility, nutrition, and providing support and education
ataxia
Extrapyramidal: Wide based gait with coordination difficulty, lack of coordination with purposeful movements
lumbar puncture
Diagnostic test which is the withdrawal of CSF from the subarachnoid space (space between L3 and L4 or L4 and L5) for analysis. Measure spinal fluid pressure and detects infection (meningitis).
Procedure: Have pt. void before procedure, apply topical anesthetic for 45 min to 1 hr. prior to procedure, place pt. in side-lying position with head flexed and knees to chest, client can be sedated, place pressure dressing after procedure, monitor site for bleeding, hematoma, or infection.
Post procedure: Pt. should remain in bed in flat position to prevent leakage which can result in a spinal headache.
