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Care of Child w/ Neuro Disorders Flashcards

1
Q

Types of Neurological Disorders in Children

A
  • structural disorders
  • seizure disorders
  • infectious disorders
  • trauma to neuro system
  • blood flow disruption disorders
  • chronic disorders
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2
Q

3-4 Weeks Gestation Neuro A&P

A

infection, trauma, teratogens, and malnutrition can cause physical defects and may affect normal CNS development

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3
Q

Birth Neuro A&P

A

cranial bones well developed, but not fused: increased risk for fracture

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4
Q

Child Neuro A&P

A

spinal cord is mobile; high risk for cervical spine injury

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5
Q

Factors Affecting Neuro Disease in Child

A
  • premature
  • difficult birth
  • infection during pregnancy
  • n/v, headache
  • changes in gait
  • falls
  • visual disturbance
  • recent trauma
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6
Q

What do we inspect/observe in child w/ Neuro Disorder?

A
  • LOC
  • vitals
  • head, face, neck
  • cranial nerve function
  • motor/sensory function
  • reflexes
  • increased intracranial pressure
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7
Q

If the child’s eyes are sunsetting what does that mean?

A

increased intracranial pressure

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8
Q

What is the earliest indicator of improvement or deterioration of neuro status?

A

Level of consciousness

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9
Q

Five States of Consciousness

A
  • full consciousness
  • confusion
  • obtunded
  • stupor
  • coma
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10
Q

Full Consciousness

A

child is awake and alert
oriented to time, place, and person
exhibits age appropriate behaviors

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11
Q

Confusion

A

disorientation exists

child may be alert but responds inappropriately to questions

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12
Q

Obtunded

A

child has limited responses to the environment and falls asleep unless stimulation is provided

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13
Q

Stupor

A

child only responds to vigorous stimulation

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14
Q

Coma

A

child cannot be aroused, even w/ painful stimuli

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15
Q

What neuro disorders would you do frequent vitals for?

A 
Cerebral infection
Increased ICP
Coma
Brain stem injury
Head injuries
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16
Q

Alterations in motor function may indicate what?

A

Certain neuro problems such as: increased ICP, head injury, and cerebral infections

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17
Q

What are the two important distinct types of posturing that may occur?

A

Decorticate posturing

Decerebrate posturing

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18
Q

Decorticate Posturing

A

occurs w/ damage of cerebral cortex
extreme rigid muscle tone
extremities flexed

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19
Q

Decerebrate Posturing

A

occurs w/ damage at the level of the brain stem
extreme rigid muscle tone
extremities extended and pronated

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20
Q

Cranial Nerve I

A

sense of smell
have child close eyes and tell you what they smell
NOT for infants

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21
Q

Cranial Nerve II, III, IV, VI

A

vision, motor control, eye movements, eye muscles

follow an object, visual acuity tests, check pupils

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22
Q

Cranial Nerve V

A

mastication muscles

sensation: pacifier, bite, light touch on face

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23
Q

Cranial Nerve VII

A

facial muscle, salivation, taste: smiles, cries, taste

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24
Q

Cranial Nerve VIII

A

hearing-response to voice, whisper

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25
Cranial Nerve IX, X
motor impulses to heart, swallowing, gag reflex
26
Cranial Nerve XI
impulses to shoulders and pharynx-head position in sitting position, shoulder shrug
27
Cranial Nerve XII
impulses to tongue and skeletal muscles-tongue movement
28
How do we manage disturbed sensory perception?
- assess for changes in sensory perception - monitor for risk of injury secondary to sensory changes - notify doctor/crnp of changes - assist child in learning adaptive methods - provide familiar sounds
29
Infant Reflex Assessment
moro tonic neck withdrawal
30
Common Lab and Diagnostic Tests
``` lumbar puncture head and neck radiograph fluoroscopy cerebral angiography ultrasound CT scan EEG MRI PET scan ICP ```
31
What are some medications used to treat neuro disorders?
``` antibiotics anticonvulsants benzodiazepines analgesics osmotic diuretics corticosteroids ```
32
What are some medical treatments used for neuro disorders?
``` shunt placement ventilation PT/OT/ST external ventricular drainage ventricular tap vagal nerve stimulator ketogenic diet ```
33
Seizure Disorders
epilepsy febrile seizures neonatal seizures
34
Epilepsy
- two or more unprovoked seizures, which occur more than 24 hours apart - one unprovoked seizure and a chance of further seizures the same as the general recurrence risk after 2 unprovoked seizures, happening over the next 10 years
35
What are some risk factors for Epilepsy?
- family history - any complications during prenatal, perinatal, or postnatal periods - changes in developmental status or delays in milestones - any recent illness, fever, trauma, or toxin exposure
36
What should be the goal for every child put on seizure meds?
use the fewest drugs w/ the fewest possible side effects for the control of seizures
37
Nursing Management for Epilepsy
preventing injury appropriate meds and treatment education and support
38
Common types of Seizures
``` infantile spasms absence tonic-clonic myoclonic atonic simple partial complex partial status epilepticus ```
39
Common types of Structural Defects
``` Neural Tubal Defects Microcephaly Arnold-Chiari Malformation Hydrocephalus Intracranial Arteriovenous Malformation Craniosynostosis ```
40
Examples of Neural Tube Defects
Spina bifida occulta Myelomeningocele Anencephaly Encephalocele
41
Anencephaly
small or missing brain
42
Encephalocele
protrusion of the brain and meninges through the skull
43
Microcephaly
head circumferencemore than 3 standard deviations below the mean
44
Arnold-Chiari Malformation
Type 1/Type 2 Type 1- adolescents w/ neck pain and headaches Type 2-at birth/infants
45
Hydrocephalus
imbalance and absorption of CSF | CSF accumulates in the ventricles
46
Intracranial Arteriovenous Malformation
rare congenital disorder
47
Craniosynostosis
premature closure of the cranial sutures; complete closure of all sutures does not normally occur until late in childhood
48
Premature closure of the cranial sutures can cause what?
inhibit brain growth and a distorted skull appearance will be evident
49
Positional Plagiocephaly
asymmetry in head shape encourage tummy time avoid excessive use of car seat may benefit from helmet
50
Signs and Symptoms of Shunt Infection
``` elevated vitals poor feeding vomiting decreased responsiveness seizure activity signs of local inflammation along shunt tract ```
51
Types of Infectious Disorders of Neuro System
Bacterial meningitis Aseptic meningitis Encephalitis Reye Syndrome
52
Encephalitis
inflammation of the brain that may also include an inflammation of the meninges and can be caused by protozoan, bacteria, fungal or viral infection
53
Bacterial Meningitis
``` Medical emergency Prompt hospitalization LP and cultures IV antibiotics treatment Abrupt eruption of petechial or purplish rash ```
54
Abrupt eruption of petechial or purplish rash can indicate what?
Meningococcemia
55
Reye Syndrome happens primarily in who?
children less than 15 years old
56
Reye Syndrome
brain swelling, liver failure, and death in hours
57
What are some causes of Reye Syndrome?
- viral illness-chicken pox, croup, flu, or upper resp infection - ingestion of salicylate-containing products w/in 3 weeks of start - Pepto-Bismol, Alka-Seltzer
58
Risk Factors for Birth Trauma
``` multiple deliveries large for date infants extreme prematurity large fetal head congenital anomalies ```
59
Causes of Nonaccidental Head Trauma
Violent Shaking: shaken baby syndrome Blows to head Intentional Cranial Impacts against the wall, furniture, or the floor
60
Cerebral Vascular Disorder is usually seen when?
after first month of life
61
Periventricular/intraventricular hemorrhage is seen in who?
preterm infants and in infants up to 1 month of age
62
Signs/Symptoms of Acute Stroke in Children
weakness on one side or hemiplegia facial droop slurred speech speech deficits
63
Migraines
specific type of headache-benign, recurrent throbbing headaches often accompanied by N/V, photophobia
64
What are some causes of headaches?
``` sinusitis eyestrain stress brain tumors acute meningitis increased ICP ```
65
What to do for headaches?
- thorough physical exam w/ detailed neuro exam - may need neuroimaging to r/o tumor - keep headache diary - avoid caffeine, avoid dehydration - exercise, proper diet, sleep regulation
66
Breath holding
- benign behavior for children - stops inhaling/exhaling or hyperventilates - brain becomes anoxic - becomes cyanotic and passes out - resolves spontaneously - w/ LOC child begins breathing
67
At what age is breath holding most likely to occur?
1-3 years old
68
How long does the breath holding episode last?
30-60 seconds
69
What should you check for w/ breath holding?
iron deficiency

Pediatrics (24 decks)

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