Chapter 12: Neurological Flashcards
What are the different types of seizures in children?
Absence: Brief LOC, lip smacking, daydream-like; common in school-age kids.
Partial: One hemisphere involved; may have aura; symptoms depend on brain region.
Generalized: Both hemispheres; starts with tonic phase (stiffening), then clonic phase (jerking); LOC present.
Febrile: Triggered by fever >101°F; usually occurs in kids 6 mo – 5 yrs; lasts <15 mins, rarely recurs within 24 hrs.
What are febrile seizures and why do they happen?
Benign seizures caused by rapid rise in temperature; nervous system is immature and sensitive to fever spikes.
What is status epilepticus?
A seizure lasting >30 minutes. Medical emergency—monitor glucose, electrolytes, ABGs, temp, BP.
What nursing interventions should be done for seizures?
Maintain airway (jaw thrust if needed).
Do not place anything in the mouth.
Turn on side, remove hazards, loosen clothing.
Administer benzodiazepines (1st line), then AEDs.
Monitor for postictal phase (decreased LOC).
Provide emotional support and education.
What is meningitis?
Inflammation of the meninges (brain/spinal cord covering), caused by viral or bacterial infection.
How do viral and bacterial meningitis differ?
Viral: Common, less severe, child looks less ill, full recovery expected.
Bacterial: More virulent, rapid progression, can be fatal—especially in infants.
What are the symptoms of meningitis?
Young children: Hypothermia, feeding changes, vomiting/diarrhea, bulging/flat fontanel.
Older children: Fever, irritability, altered LOC, headache, muscle/joint pain, nuchal rigidity, Kernig & Brudzinski signs.
What is the treatment for each type of meningitis?
Bacterial: Immediate IV antibiotics.
Viral: Supportive care after ruling out bacterial.
What are nursing considerations for meningitis?
Assessment, med admin, seizure precautions, monitor LOC, vital signs, environmental safety.
How do you assess Kernig’s sign?
Flex the hip and extend the knee—pain/resistance = positive sign of meningeal irritation.
How do you assess Brudzinski’s sign?
Flex the neck—if hips and knees also flex, this is a positive sign.
What is hydrocephalus?
Imbalance in CSF production/absorption → increased CSF in ventricles → ↑ ICP.
What are the types of hydrocephalus?
Communicating: CSF flows normally but isn’t absorbed.
Non-communicating: Blocked CSF flow (most common in kids).
How is hydrocephalus treated?
VP shunt or EVD to drain CSF and reduce pressure.
What is a VP shunt?
A ventriculoperitoneal shunt diverts CSF from brain to peritoneal cavity to reduce ICP.
What are signs the VP shunt is malfunctioning?
Signs of ↑ ICP: vomiting, lethargy, irritability, headache, bulging fontanel, increased head size.
What are nursing considerations for VP shunt?
Monitor for infection, assess neuro status, educate parents on signs of malfunction.
What are signs of increased ICP?
Headache
Vomiting
Decreased LOC
Irritability
Blurred vision
Bulging fontanel (infants)
Increased head circumference
High-pitched cry
What is spina bifida?
Neural tube defect where spine doesn’t close completely—ranges in severity.
What are the types of spina bifida?
Occulta: Vertebral defect only; no herniation; skin may appear normal.
Meningocele: Meninges protrude through vertebrae; no nerve involvement.
Myelomeningocele: Most severe—spinal cord and meninges protrude into a sac; high risk for paralysis and hydrocephalus.
What is nursing management for spina bifida (pre-op)?
Prone positioning
Keep sac moist and sterile
Monitor for CSF leak or infection
Skin care
Assess extremities, I/O
What is post-op care for spina bifida?
Continue prone/side-lying
Pain management
Monitor head circumference (risk for hydrocephalus)
Prevent infection, bowel/bladder monitoring
Support family
What is cerebral palsy (CP)?
Non-progressive, permanent motor disorder caused by brain injury before/during birth.
How might a child with CP present?
Poor head control after 3 months
Stiff or floppy tone
Delayed milestones
Clenched fists >3 months
Persistent primitive reflexes
Arching back or pushing away
