cerebral dysfunction

Question 1

increased ICP

s/s and treatment - infants

Answer 1

high pitched cry
tense fontanels
drowsy
poor feeds

T= head of bed 15-30 degrees
avoid activities
cluster care

Question 2

increased ICP

s/s and treatment - children

Answer 2

head, NV, diplopia, seizures, drowsy, decline in School, decreased activity

T= minimal noise / visitors
avoid suction

Question 3

increased ICP

late signs

Answer 3

bradycardia, decreased LOC, pupil size change, posturing, papilledema

meds = sedatives, paralytics, osmotic diuretic (mannitol)

Question 4

epidural hematoma

Answer 4

lucid period followed by RAPIDLY altered mental state

T= control headache, minimize stimulation, surgery

Question 5

subdural hematoma

Answer 5

SLOWER to develop (S = slower / subdural)
irritable, vomiting, inc. head circumference, bulging fontanels

seizure precaution
HOB elevated
frequent loc assessments

Question 6

herniation

Answer 6

brain pushes through brain stem

cushings triad: hypertension, bradycardia, respiratory depression

Question 7

encephalitis

Answer 7

malaise, fever, head, dizzy, apathy, nuchal rigidity, tremors, speech difficulty

T= supportive care, icp monitoring

can be devastating

Question 8

rabies

Answer 8

plenty of time to receive care because incubation time is 1-3 months
once symptoms appear = fatal

T= vaccine / immunoglobulins

Question 9

reye syndrome

Answer 9

follows a viral illness
educate parents = no aspirin / Tylenol
profuse vomit, lethargy that can quickly become near impairment,

Question 10

tonic clonic seizure

Answer 10

tonic = stiff, eyes roll, loss of consciousness

clonic - intense jerking, incontinence

Question 11

absence seizure

Answer 11

brief loss of awareness, blank stare, multiple times / day, can resume activities right away

Question 12

atonic

Answer 12

momentary / total loss of muscle tone, head drops or falls to ground

Question 13

myoclonic

Answer 13

brief jerking movements of a muscle- single or repetitive

Question 14

status epilepticus

Answer 14

seizure > 5 mins

Question 15

febrile seizure

Answer 15

associated with febrile illness (temp >100.4)
6-60 months old
educate parents= bring child in if it lasts > 5 mins

Question 16

acute headache

Answer 16

sinusitis, ocular abnormalities, dental, respiratory infections, trauma

Question 17

acute, recurrent (migraine)

Answer 17

N,V, fatigue, pallor, family history

triggers: stress, exercise, menses, meds, diet, no sleep, environment

Question 18

chronic progresive

Answer 18

inc. ICP, tumors (early morning headache), hydrocephalus, subdural

Question 19

chronic nonprogressive

Answer 19

tension headaches: common in children, adjustment reaction, anxiety

Question 20

migraine w/aura

Answer 20

aura may be visible
most common
hemiparetic: numb lips, lower face

aura lasts < 1 hour followed by throbbing headache, N,V, photophobia

Question 21

migraine w/o aura

Answer 21

pallor, alteration in personality, change in appetite

N,V, photophobia, photophobia, pulsating

Question 22

sporadic hemiplegic migraine

Answer 22

migraine w/aura
motor weakness
no family history

Question 23

bailar type migraine

Answer 23

recurrent attacks, occipital, dysarthria, vertigo, diplopia, vomit, altered consciousness

Question 24

hydrocephalus

Answer 24

imbalance in production / absorption of CSF

causes = congenital malformation, infection, hemorrhage, tumor, or head injury

infants = head enlargement, bulging fontanels, irritability, poor feeds, altered LOC
kids = increased ICP, irritable, lethargy, confused, incoherent
t = shunt