Ch. 45 Cerebral Dysfunction Flashcards
As intracranial pressure increases does level of conscious increase or decrease
Decrease
Define coma
No motor or verbal response or extension posturing to noxious stimuli
Define Stupor
Remaining deep sleep, slow response to stimuli
Define lethargy
Limited spontaneous movement, sluggish speech, drowsy, falling asleep easily
When should the Babinski reflex disappear in infants
Around 1 years old- 18months
Define obtundation
Arousal with stimulation
What are the three categories that make up the Glasgow coma scale
Eye opening
Verbal response
Motor response
A score of a 15 on the Glasgow coma scale indicates
Unaltered LOC
A score of 8 or below on the Glasgow Coma scale indicates
coma
A score of 3 on the Glasgow coma scale indicates
Deep coma
T/F a sudden appearance of a fixed and dilated pupil is a neurologic emergency
True
Why is the oculovestibular (caloric test) never performed on an awake child
It invokes the installation of ice water into the ear of a comatose child, it is painful
What is the priority nursing intervention when a child is unconscious
Establish and adequate airway
What is Mannitol used for
Treat children who has increased ICP resulting from cerebral edema
Define concussion
Most common head injury, alteration in neurologic or cognitive function with or without loss of consciousness
Define Contusion
Represent petechial hemorrhages or localized bruising along superficial aspects of brain
Define linear fracture
Single fracture line that starts at the point of maximum impact but does not cross suture lines
Define depressed fracture
Are those in which the bone is broken locally, usually into several irregular fragments that are pushed inward causing pressure on bone
Define Comminuted fracture
Consist of multiple associated linear fractures
Define open fractures
cause communication between the skull and the scalp or mucosa of the URT
Define growing fractures
Skull fractures associated with an underlying dual tear that may be caused by cyst
Define epidural Hemorrhage
Bleeding b/w the Duran and the skull to form a hematomas, this bleeding causes the Duran to be stripped from bone, forcing underlying brain contents downward and inward as the brain expands
Define subdural hemorrhage
Bleeding b/w the Duran and the arachnoid membrane(cerebrum), usually as a result of rupture of cortical veins that bridge the subdural space
Deep rapid, periodic, intermittent gasping respiration, slowing pulse, fluctuations in blood pressure are signs of
Brainstem involvement brain injury
Can bacterial meningitis be prevented
Yes with use of H influenza type B vaccine
What are some of the clinical manifestations of ICP in infants
Bulging fontanel, irritability, high pitched cry, poor feeding, setting sun sign
What are some of the clinical manifestations of ICP in children
Headache, nausea, diplopia, blurred vision, seizures increased sleeping, inability to follow simple commands
What are late signs of ICP in infants and children
Bradycardia, extension, posturing, cheyne-stokes restorations, alteration in pupil size
What are some clinical signs that confirm meningitis in a neonate
Bulging anterior fontanel, weak cry, poor muscle tone
