Cerebral Palsy, Spinal Muscular Atrophy, Neural Tube Defects Flashcards
TRUE OR FALSE
Cerebral Palsy is a progressive disorder of movement and posture.
FALSE
It is NON-PROGRESSIVE
What does “palsy” mean?
poor muscle control/muscle weakness because of something neuro
TRUE OR FALSE
We will have pt’s admitted for cerebral palsy.
FALSE
There is nothing to be done about cerebral palsy. They would be admitted for symptoms of their condition, not the condition itself
What are some basic things we need to keep in mind when we care for a pt w/ cerebral palsy?
- It is a non-progressive disorder
- What’s going on with their muscles is not necessarily what’s going on inside of their minds
- They may not be able to speak or move a lot, but they’re still there and we communicate with them at their developmental level
- CP has a wide range of affliction and can be mild or severe
A CP pt with poor swallow and risk of aspiration may be admitted for…
- Pneumonia,
- Nutrition Assessment,
- GT Placement
A CP pt with severe spasticity, or mobility/alignment issues may be admitted for…
orthopedic surgery
A CP pt with bladder issues, frequent UTIs, or incontinence may be admitted for…
GU surgery
If a test question stated “There is a patient with aspiration and cerebral palsy”, what is the issue and why?
- aspiration is the issue
- we can’t treat cerebral palsy
What is Baclofen
used for,
how is it administered
and why?
- It is used to decrease muscle spasticity
- It is administered interthecally via pump that provides a steady dose
- The steady dose reduces possible sfx (over oral administration)
What are the key points to remember about the Baclofen pump?
- Pump sits inside the skin of the abdomen
- Pump is refilled @ the Dr’s office every 2-6mos
- batteries can last 6-7yrs
How does Baclofen work?
It blocks activity of nerves in the part of the brain that controls the contraction and relaxation of skeletal muscles to help them relax.
What CP patient may have a Baclofen pump installed?
a CP pt w/ severe contractures
What are the three neural tube defects we need to know?
- Anencephaly
- Spina Bifida Occulta
- Spina Bifida Cystica
Describe ancephaly.
- “An” means without, “cephaly” means brain.
- A baby can actually be born w/out a fucking brain.
- Nothing to know/say about it.
- It will die.
What are the key points to remember for Spina Bifida Occulta?
- hidden split in spine
- Least serious, but most common type
- Sacral dimple w/ some odd hair is what you’ll see
- Some kids w/ this have no problems at all and may not even know they have it unless they have a back xray taken
What are the two types of Spina Bifida Cystica?
Briefly describe each.
- Meningocele
- no spinal cord damage
- least common form of spina bifida
- Myelomeningocele
- most severe
- meninges and spinal cord are pushed out and damaged
- They can occur anywhere along the spine, but typically in the lower back
- They may also have hydrocephalus - because the flow of CSF can get blocked and backed up and can cause some issues up there
What is our nursing care for a newborn with a myelomeningocele?
- Cover w/ WARM cloth
- Protect and keep moist (w/ sterile saline)
- don’t want the site to dry/crack
- change dressing every 2-4hrs
- Will have surgery very quickly after birth for this
What is our pre-op nursing care for a newborn with a myelomeningocele?
- Keep site moist (sterile dressing with saline)
- Prone position
- Inspect site for leaks
- Watch closely for developing infection or increased ICP
What is our post-op nursing care for a newborn with a myelomeningocele?
- Prone or side-lying position
- Same as any post-op
- I/O
- Monitor for infection - like a lot a lot
- Pain ctrl
- Neuro checks
- Location of site will determine type of care needed
What are the long-term care issues to keep in mind for a child born w/ myelomeningocele?
- Orthopedic Considerations
- Management of Genitourinary Function
- Bowel Control
