Case Study #4 Cerebral Palsy Flashcards
Describe the classifications, common causes and risk factors for developing cerebral palsy
Spastic
- damage to motor cortex
- most common, muscle tightness, hypertonic with a neuromuscular mobility impairment
- muscles affected become active together and block effective movement
- results in constant tense of muscle
Ataxic (shaky movements)
- damage to the neurons in the cerebellum which regulate movement
- hypotonic and experience tremors
- writing, typing, using scissors as well as balance are affected
- unstead gait, balance problem
Athetoid (dyskinetic)
- mixed hypertonic and hypotonic
- trouble holding upright
- steady position for sitting or walking
- damage to the basal ganglia
- experience involuntary movements
- dystonia = twisting movements & posturing of trunks or limbs
Causes and Risk factors
- birth asphyxia
- damage to the motor control centers of the developing brain and can occur during pregnancy, childbirth, or after birth
- toxins, jaundice, lead, shaken baby syndrome, brain injury, drowing, encephalitis, meningitis
- problem with intra-uterin development, congenital
- preterm
Describe the health assessment and nursing process for a child with cerebral palsy and its associated conditions
- Make the environment comfortable for joyce
- Use open-ended question, be approachable for her
- Re-assure that Candy is being taken care of
- Employ active listening
- Demonstrate patience and helping the parent stay on track
- Speak to Joyce for patient’s history
- Candy’s allergy history, medication history, medication reconciliation, and previous admission
- Developmental level of speech, vision, hearing
- Communication techniques
- Reason for admission
- Last feed
- In and Out
Describe the pharmacological interventions for cerebral palsy and its associated conditions
-Antispasmodics
o Most common used for CP, they help relax tight muscles and reduce muscle spasms. These are usually taken orally: diazepan, baclofen, and dantrolene. Side effect includes constipation, diarrhea, incontinence, nausea, and malaise
-Anticonvulsant
o Used to treat with seizures. They reduce or prevents seizure activity and can also stabilize move. Phenytoin, gabapentin, lamotrigine, and topiramate. Side effect include constipation, convulsion, dizziness, drowsiness, and fatigue
-Anticholinergics
o Help those who has uncontrollable body movement who drool frequently and includes benztropine (anti-parkinson agent: reduction of rigidity and tremors), cardipoda-levidopa, glycopyrolate, and trihexypheridyl. Mild side effects: dry mouth, blurred vision, and constipation
-Antidepressant
o Can be used to treat seizures. 1/3 of patient may be depressed along with CP. Citalopram, paroxetine, sertraline Side effect: constipation, dizziness, dry mouth, upset stomach and nausea, agitation
-Anti-inflammation
o Be used persistent pain by reducing or alleviating inflammation. These could be include gastrointestinal pain, orthopedic pain, pharmaceutical intervention, and rehabilative therapies. These could include aspirin, corticosteroid, NSAIDs, or steroids. SIDE EFFECTS: indigestion, hemorrhage, or gastric ulcer
-Stool softeners
o Help with constipation. Common in children with CP because of lack of activity, medication, inadequate fluid, labored breathing. Side effect can include stomach or intestinal cramps, nausea.
discuss the special health challenges faced by adults with cerebral palsy
- Athritis
- Scoliosis
- Stigma
- Depression
- Anxiety
- Pneumonia
- Skin impairment
- Decreased senstations
- Urinary retention
- Incontinence
- Constipation
- Decreased bone densitiy
- Seizure
- Weight gain
- Development delays
- Leanring disabilities
- All these complication will impede candy’s quality of life
- Candy will lack independence throughout her life
- Unable to have normal relationship (eriksson theory for early adulthood intimacy vs isolation
