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Holistic Maternal and Child Nursing: Pediatrics > Chapter 13 - Neurological and Sensory Disorders > Flashcards

Chapter 13 - Neurological and Sensory Disorders Flashcards

1
Q

West Nile Virus can cause:

A

encephalitis.

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2
Q

What is the central component of the Nervous System?

A

Neuron

the smallest part, the Nerve Cell

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3
Q

What is Dandy-Walker syndrome/malformation?

A

it is a malformation of the Cerebellum and fluid-filled spaces around it.

Congenital brain malformation.

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4
Q

Dystonia is:

A

muscle contraction and twisting movements of muscle groups; abnormal posture

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5
Q

What are two other AKAs for Spina Bifida?

A
  1. Myelomeningocele

2. Neural Tube Defect

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6
Q

What is Meningocele?

A

Membrane around the SC (spinal cord) is enlarged, creating a mass.

Root word: mening/i/o = meninges (membranes of the CNS)
suffix cele = protrusion of; hernia; swelling

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7
Q

4 types of nonviral causes of Encephalitis are:

A
  1. Bacteria
  2. Parasites
  3. Fungi
  4. Rickettsiae
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8
Q

Anticonvulsant medications for seizure disorder are:

A 
Valproic acid (depakene)
Phenytoin (dilantin)
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9
Q

Diagnostic evaluation of Reye Syndrome includes:

6 items

A
  1. history, revealing recovery from a recent viral disease
  2. sudden onset of vomiting and mental confusion
  3. Elevated Liver enzymes
  4. Below normal Blood Glucose
  5. Elevated Ammonia levels
  6. Prolonged partial thromboplastin time
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10
Q

Name 4 kinds of Movement Disorders in children.

A
  1. Tics
  2. Tremors
  3. Dystonia
  4. Chorea
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11
Q

What is a petit mal seizure?

A

staring seizure, or absence seizure, a brief loss of awareness.

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12
Q

What is agenesis of the Corpus Callosum?

A

Absence of the structure that connects the 2 hemispheres. Congenital brain malformation

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13
Q

Meningitis is a precursor to:

A

Encephalitis.

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14
Q

Febrile Seizures are due to:

A

fever, in young children.

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15
Q

Alterations in the firing of neurons in the brain are:

A

seizures

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16
Q

What is the most common cause of acute paralysis in children?

A

Gullain Barre Syndrome

GBS

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17
Q

Hydrochephalus occurs as a result of:

A

an IMBALANCE between CSF production and absorption.

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18
Q

A complete loss of tendon reflexes occurs with G_____ B_____ Syndrome

A

Gullain Barre

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19
Q

3 signs of Cushing’s Triad

A
  1. Bradycardia (tachycardia that leads to bradycardia)
  2. Irregular respiratory pattern
  3. Systolic hypertension with WIDE pulse
    pressure.
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20
Q

List 3 kinds of Infectious Neurologic health problems:

A
  1. Meningitis
  2. Encephalitis
  3. Reye Syndrome
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21
Q

If a child has meningitis, it is treated as a:

A

medical emergency

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22
Q

The most common reason for a shunt revision is:

A

a child’s growth

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23
Q

List 7 symptoms of Meningitis

A
  1. Severe headache
  2. Stiff neck
  3. Sudden high fever
  4. Bulging fontanels (infants)
  5. Altered mental status
  6. Depending on age: irritability or sleepiness
  7. May have a RASH, with certain bacterial infection
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24
Q

The general public often mistake tics to be:

A

voluntary.

Tics are involuntary. It can cause a child to be disciplined even though it is a medical condition.

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25
Q

Generalized seizures have what type of body movements associated with it?
(2 items)

A

Tonic (rigid)

Clonic (jerking)

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26
Q

Two classification of Meningitis is:

A
  1. Viral

2. Bacterial (strep pneumonia)

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27
Q

It is important for the nurse to teach the family with a child who has epilepsy to:

A
  1. medication effects and side effects
  2. obtain a med alert bracelet for child to wear
  3. find alternatives for contact sports
  4. avoid swimming or climbing along
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28
Q

Children with SB (spina bifida) have a 50% chance of having what type of allergy?

A

Latex allergy

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29
Q

Vertebrae are completely ossified at birth.

True or False

A

False

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30
Q

What are LATE signs of Hydrocephalus in an older child?

there are 6 signs

A

Late signs of Hydrocephalus in an older child:

  1. Seizures
  2. BP increased
  3. Blindness from herniated of Optic disc
  4. Decerebrate rigidity
  5. Heart rate decreased
  6. Respiratory pattern altered
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31
Q

Chorea resembles:

A

dancing movements.

muscle contractions result in quick, rhythmic movements.

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32
Q

If there is malformation or damage to any area of the CNS, what is the result?

A

Some form of IMPAIRMENT

Damage/Malformation = impairment

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33
Q

What are 2 primary ways to diagnosis an infant/child with Cerebral Palsy?

A
  1. Neural exam

2. Health history (neural)

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34
Q

List 3 clinical manifestations of Battle Sign

A
  1. leakage of CSF from nose or ears
  2. Raccoon eyes, periorbital ecchymosis.
  3. Bruising behind the ears
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35
Q

5 Behavioral signs of Cerebral Palsy are:

A
  1. extreme irritability or crying
  2. does not smile by 3 months old
  3. feeding difficulties
  4. persistent gagging or choking when fed
  5. persistent extrusion reflex after 6 months old.
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36
Q

Ominous sign for the eyes is?

A

Pupils are dilated and fixed.

a nerve is compressed (Oculomotor nerve)

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37
Q

What are the 2 early Signs of Hydrocephalus: in an older child with Hydrocephalus, compared to symptom for an infant with Hydrocephalus?

A

Older child = headache + strabismus

Infant = head size increase + fontanel bulging.

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38
Q

Which type of muscular dystrophy is more common in boys?

A

Duchenne’s muscular dystrophy

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39
Q

What type of DME may assist a child with Cerebral Palsy?

A

Splints,
Braces,
Adaptive feeding devices.

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40
Q

Tethered Cord Syndrome is:

A

limited spinal cord movement inside the spinal column

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41
Q

What is the nonprogressive motor disorder of the CNS called?

A

Cerebral Palsy

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42
Q

What type of headaches do most children experience?

2 types

A

Tension headache,

Migraine

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43
Q

What is Meningitis?

A

You should know this by now.

itis = inflammation
mening = meninges (membrane of the CNS)
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44
Q

Assessing Level of Consciousness using
the Glasgow Coma Scale (GCS).

List 4 general things about the GCS

A
  1. Nurse uses the scale to apply a value from 1-15
  2. Provides clues to neurological status
  3. Categories: eye opening, motor response and verbal response
  4. 0-3 is Deep Coma
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45
Q

List 7 items in a General Assessment of the Pediatric Nervous System

A
  1. gather History (of pregnancy and Family hx) [Listen]
  2. LOC and Glasgow Coma Scale (level of consciousness)
  3. Ht and Wt (measure)
  4. Head (circumference, suture lines and anterior fontanel)
  5. Developmental Milestones
  6. Assess behavior, (and describe it), interactions and general appearance.
  7. VS, for baseline. (vital signs)
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46
Q

Cyclic vomiting is treated with:

A

antidepressant,

amitriptyline

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47
Q

Neurological Assessments

identify 6 assessment items

A

Assess:

  1. EYES (eg. response, size, funduScopic exam)
  2. Cranial nerves
  3. Coordination (is there any?, eg. throwing a ball)
  4. Mental Status (for school-age & adolescents)
  5. Motor Fxn (eg. strength, tone, smooth, purposeful movement)
  6. Sensory Fxn (eg. deep tendon reflexes & other appropriate reflexes)
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48
Q

It is a common skull fracture that occurs with children.

A

Battle sign

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49
Q

What type of diuretic would you administer to a child with ICP?

A

Mannitol,

it is an osmotic diurectic.

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50
Q

List 3 general concepts about Assessment of the Pediatric Nervous System

A
  1. Children under the age of 2: require special evaluation
  2. Most info is gained through OBSERVING spontaneous and elicited REFLEX RESPONSES.
  3. Red Flags = Delay or deviation from expected milestones, OR, re-appears of primitive reflexes
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51
Q

A priority nursing consideration pre-surgery for a child with Spina Bifida is:

A

maintain skin integrity of the sac.

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52
Q

__% of childhood seizures are idiopathic.

A

50%

Half!

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53
Q

Symptoms of Hydrocephalus in older children:

there are 8 signs

A
  1. HeadACHE
  2. Blurred vision, or, double vision
  3. Balance problems
  4. Lethargy
  5. New urinary incontinence
  6. Papilledema (swollen optic disc)
  7. Sunsetting Eyes
  8. Vomitting
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54
Q

A seizure that lasts 30 minutes or more is:

A

a pediatric emergency, aka status epilepticus

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55
Q

Anencephaly is:

A

a congenital malformation, where both cerebral hemispheres are ABSENT.
Stillborn infants have this defect. so sad!!!

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56
Q

What are the 3 diagnostic tests help verify Meningitis?

A
  1. Lumbar puncture
  2. Blood cultures
  3. Nose and throat cultures
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57
Q

What is Post concussion Syndrome?

A

Child may become easily upset and may be irritable if tired or stressed.
Memory problems are common.
Double vision, dizziness, headaches, may last for months.

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58
Q

States of Consciousness in a patient

Lists 5 states of consciousness

A
  1. Alert
  2. Lethargy
  3. Obtundation
  4. Stupor
  5. Coma
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59
Q

Narcolepsy is:

A

extreme tendency to fall asleep, at inapropriate times

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60
Q

Hypersomnia is:

A

excessive sleepiness, sleeping at inapropriate times

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61
Q

Name 4 common neuromuscular disorders.

A
  1. Cerebral palsy
  2. Muscular dystrophy
  3. Myasthenia gravis
  4. Spinal muscle atrophy
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62
Q

Performing a Lumbar Puncture

List 6 things to consider while performing a Lumbar Puncture.

A
  1. Instruct child to lie on side
  2. Instruct child to bend knees, until knees touch chin
  3. Wash back ( cool liquid)
  4. Tell child, will feel a “pinch” or “sting”
  5. Check CardioPulmonary status
  6. Support client and family
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63
Q

Encephalitis is usually caused by a:

A

Virus

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64
Q

List 3 important Nursing Interventions for Meningitis.

A
  1. Isolation
  2. Monitor Neurologic Status (LOC)
  3. Monitor IV fluids

Other Nursing Interventions:
monitor Cardiorespiratory status (frequent VS)
have emergency airway equipment in room/bedside
provide env’t that will minimize ICP
monitor for cerebral edema
Doctor’s orders: antipyretics, administer as ordered
monitor for complications such as seizure, hearing loss, visual alterations

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65
Q

Identify 4 Nursing Intervention for Teaching Parents to care for child with a Head Injury:

A
  1. Ice (to child’s head)
  2. Rest (for the child)
  3. Limit foods, if child vomits
  4. Watch for 2 full days. Awaken child at parent’s bedtime and again 4 hours later to make sure child is alert and can answer your questions appropriately
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66
Q

When to call the physician immediately for a head injury:

the list is long, 10 items

A
  1. bleeding that does not stop after putting pressure for 10 minutes on area.
  2. needs sutures
  3. under 1 yr old
  4. Unconscious or confused
  5. Severe headache, vomitting
  6. Slurred speech, blurred vision
  7. Blood or watery fluid coming from ear or nose
  8. Unequal pupils or crossed eyes
  9. Difficulty walking or crawling, or weakness in the arms.
  10. Other symptoms that concern you.
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67
Q

What is Lissencephaly?

A

Absence of folds, grooves and fissures of the brain.

Congenital brain malformation.

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68
Q

Is transient neonatal Myasthenia Gravis a real thing?

A

yes.

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69
Q

Gullain Barre Syndrome requires a ___________ assessment. Deaths are due to __________ failure.

A

Respiratory,
respiratory
(yes, same word twice for fill in the blanks).

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70
Q

List 9 Diagnostic tests of the NS (Nervous System)

A
  1. CT scan
  2. AngioGraphy
  3. EchoEncephaloGraphy
  4. ElectroEnchephaloGraphy (electrodes)
  5. Lumbar Puncture
  6. MRI (head is restrained)
  7. Nuclear Brain Scan
  8. Subdural Tap
  9. Ventricular Puncture
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71
Q

Becker’s muscular dystrophy is:

A
  1. progressive weakness in the pelvis and legs (over time)
  2. Symptoms begin around age 12
  3. Weakness in the heart muscles can occur
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72
Q

__________ rarely occurs in infancy.

A

Papilledema (mass of blown out blood vessels are the Optic Nerve)

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73
Q

Neural tube forms the anterior end (the brain) and the posterior end (spinal cord).
If there are defects, what is the result?

A

result is defects in the brain and Spinal cord.

AKA, neural tube defects.

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74
Q

What are the affects of Sleep Disorders have on children?

list 6 items

A
  1. affect rest
  2. affect learning and behavior
  3. disruptive to family (parents/siblings)
  4. problems with insomnia
  5. problems with sleep arousal
  6. problems with early-morning awakenings
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75
Q

What is the most commong infection of the CNS?

A

Meningitis

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76
Q

The main goal for all children with Cerebral Palsy is:

A

Self-care.

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77
Q

Myoclonic seizures are:

A

sudden brief jerks of muscle groups with possible loss of consciousness.

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78
Q

List 3 kinds of Head Injuries

A
  1. Shaken Baby Syndrome
  2. Battle Sign
  3. Near Drowning
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79
Q

Neuropathy is a condition in which __________ nerves are damaged.

A

peripheral

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80
Q

What is the difference between a headaches caused from a primary or secondary cause?

A

Primary headache occurs spontaneously, NOT due to trauma, or any other problem.
Secondary headaches are due to trauma, illness, tumors.

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81
Q

An infant’s head is ___% of an Adult’s head.

A

66%

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82
Q

What is considered an Acquired Neurologic Health Problems?

A

Seizure disorders

83
Q

What is the name of the muscular dystrophy that is the least disabling of all 3?

A

Fasioscalpohumeral muscular dystrophy.

weakness in the shoulder and fascial muscles

84
Q

Shaken Baby Syndrome is:

A

a sign of physical abuse
caused by vigorous shaking of the infant.
Whiplash-induced intracranial and retinal bleeding

85
Q

Pre-operative VP shunt measurements of an infant include:

A

VS, pupil reactivity/symmetry, fontanels & suture lines, head circumference.
Remember: baseline, baseline, baseline.

86
Q

Ventriculomegaly is:

A

an enlargement of the ventricles.

It causes harmful pressure on the fragile tissues of the brain.

87
Q

What is a unique teaching piece for Encephalitis?

A

Educate family to avoid areas infected with Mosquitoes.

88
Q

What are the 2 types of Hydrocephalus?

A
  1. Congenital

2. Acquired

89
Q

4 Warning signs of a migraine are:

A

Aura,
flashing lights,
colored spots in the visual field
blurry vision

90
Q

Motor tics can involve which body parts?

7 different body parts

A 
Could be the eye,
neck,
shoulder,
nose,
teeth tensing,
chest,
abdomen.
Brief, involuntary muscle movements.
91
Q

The Nervous System has 2 main parts, what are they?

A
  1. Central Nervous System

2. Peripheral Nervous System

92
Q

Encephalitis has a wide range of clinical manifestations, what are they?

A
  1. Signs of Upper Respiratory Infection.
  2. Speech disturbances
  3. Motor dysfunction
  4. Cranial Nerve deficits
  5. Focal/generalized seizures, that alternate with periods of screaming
  6. Hallucinations
  7. Bizarre movements
93
Q

If primitive reflexes re-appear in a child at 5 months old, what does that mean?

A

It is associated with a Neurological Disease.

primitive reflexes are: moro, grasp and rooting

94
Q

Decerebrate is __________ positioning.

A

Extension

notice all of the “e’s” in the word decerebrate. associate with “extension” an ‘e’ for an ‘e’

95
Q

Spina Bifida:
immediate Post-natal Nursing consideration is:
(there are 4 items)

A
  1. MONITOR for leakage of spinal fluid from SAC as well as skin integrity of sac
  2. ASSESS for INFECTION around SAC
  3. ASSESS for Degree of SENSATION (at/below Lesion)
  4. high risk for Latex allergy (50% chance)
96
Q

Spinal Muscular Atrophy is a __________ disorder of the anterior horn cell of the ________ cord.

A
  1. degenerative

2. spinal

97
Q

What are your 5 areas of neuro nursing interventions?

A
  1. Assess (Neuro Status, VS)
  2. Maintain airway / perfusion
  3. Patient safety
  4. Lower ICP
  5. Nutrional & fluid needs
98
Q

Tics appear at what age?

A

10 years old.

Then disappear by age 18.

99
Q

Cyclic vomitting is a:

A

migraine variant with no headache.

100
Q

Spina bifida ______ is the mildest and most common form of spina bifida.

101
Q

The 2 most common neural tube defect are:

A
  1. Spina Bifida

2. Anencephaly

102
Q

Spina Bifida Myelomeningocle is:

A

Saclike Herniation contains meninges, CS and portion of SC, or, nerve roots)

Root word: myelo = spinal cord; marrow; bone marrow
mening/i/o = meninges
suffix: cele = hernia; protrusion of; swelling

(the longer the word, the worse it is!)

103
Q

Post-Surgical Shunt Placements for Hydrocephalus.

Its a long list for Nursing Considerations/interventions.

Identify 10 N-interventions.

A
  1. VS every 15 min - 1 or 2 hours, as needed.
  2. Measure, head circumference daily
  3. Elevate head, no more than 30 degrees
  4. Follow Doctors Orders: IV Antibiotics, analgesics, dressing changes
  5. Monitor shunt tract for: swelling, redness
  6. Observe for drainage (head, tummy & chest), Peritonitis (tummy pain/tenderness), LOC
  7. Position child OFF shunt site
  8. Therapeutic play, as child recovers
  9. Education for parents on home care
104
Q

What are LATE manifestations/signs of Hydrocephalus in an infant?

(there are 8 signs)

A

Late signs of Hydrocephalus for infant:

  1. Sunsetting eyes
  2. Frontal bone bossing (enlargement)
  3. BP increased
  4. Cry is high-pitched, or shrill
  5. Difficulty swallowing
  6. Feeding is difficult
  7. Heart Rate decreased
  8. Pupil response is sluggish, unequal
  9. Vomitting
105
Q

Humans are dependent on a functional Nervous System. True? or False?

106
Q

How is Hydrocephalus managed?

A
  1. preventing CSF accumulation
  2. surgery (placement of a shunt, either a ventriculoperitoneal or ventriculoatrial shunt) The tubes re-route the CSF.
  3. NURSE: monitors for Pain, infection, administers antibiotics as ordered and teaching family about dressing changes and shunt problems.
107
Q

There is an alteration in voluntary muscle control related to this cerebral insult:

A

Cerebral Palsy

108
Q

Atonic Seizures are:

A

sudden loss of muscle tone AND loss of consciousness.

AKA, drop attacks.

109
Q

The neural tube is a bundle of nerves in a human embryo.

True or False

110
Q

Gullain Barre Syndrome is an _____ inflammatory demyelinating polyneuropathy that affects the ________ nervous system.

A
  1. acute

2. peripheral

111
Q

Why does PapillEdema rarely occur in infants?

A

Because of the open fontanels and sutures. (allows for expansion)

PapillEdema is swelling inside the skull that pushes down on pupil and optic nerve.

112
Q

What are neurocutaneous disorders?

A

Disorders in the nerve cells that lead to abnormal growth of tumors in various parts of the body.
Distinct neurocutaneous lesions.

Examples:
Neurofibromatosis,
Sturge-Weber syndrome,
Tuberculosis sclerosis,
Ataxia-telangiectasia
113
Q

Myasthenia Gravis is an ____________ disease.

A

autoimmune.

predominantly weakness and fatigue.

114
Q

Abdominal migraine is:

A

migraine variant,
more common in girls
acute midline abdominal pain, nausea
may last for 1 hour to 3 days

115
Q

Vocal tics can involve:

7 items

A 
sniffing, 
clearing of the throat,
grunting,
squeaking,
humming sounds,
clicking the teeth together (yuck)
sucking sounds
116
Q

Parasomnia is:

A

abnormal behavior associated with sleep such as night terrors, sleep walking, REM sleep behavior disorder, nightmares.

117
Q

Which seizures are unique to children?

A

febrile seizures

118
Q

A spinal cord injury requires checks every 2 hours on:

A

spine alignment
Pulse oximeter
skin care, turning

119
Q

By 4th week (28th day) of Gestation, the ________ tube has closed at the anterior end to form the BRAIN.

A

Fill in the blank answer: Neural.

By 4th week (28th day) of Gestation, the neural tube has closed

120
Q

Seizures involving the entire brain are:

A

generalized seizures

121
Q

In an infant, brain growth can be screened by performing what task?

A

Measuring head circumference

122
Q

List 5 general items about Fetal Development

A
  1. Nervous System is 1st system to form in Utero (4th week)
  2. Rapid growth from 2 mo. - 5 yr old (2 months of Gestation through to 5 yrs old)
  3. Head Circumference:
    Term infant is 34-35 cm.
    6 months = 44 cm
    1 yr old = 47 cm
  4. Peripheral nerves NOT myelinated at birth
  5. Coordination and fine muscle movement improves as myelinization occurs.
123
Q

When does Reye Syndrome develop?

A

usually after a mild viral illness

such as Chicken Pox, or Influenza

124
Q

Spina Bifida Meningocele Cystica is:

A

saclike PROTRUSION contains meninges and CSF, at some point along the posterior vertebrae. it is visible.

Sensory and motor impairments

125
Q

A severe spinal cord injury will cause ________ paralysis and complete ____ of sensation below the severed level.

A
  1. complete

2. loss

126
Q

Nursing Consideration for ICP

Head of Bed elevation should be:

A

30-45 degrees

127
Q

How much CSF does an Infant have compared to an adult? (in ml)

A

Infant as 50 ml.

Adult has 150 ml.

128
Q

What are the 8 physical signs of Cerebral Palsy?

A
  1. Poor head control (after 3 months age)
  2. Stiff/rigid arms or legs (increase muscle tone)
  3. Poor sucking or swallowing
  4. Pushing away or Arching back
  5. 3 months old, has clenched fists
  6. Uses only 1 side of the body to crawl
  7. Floppy or limp body posture
  8. 8 months old, cannot sit up without support
129
Q

Seizures are diagnosed by:

A

the history of the event, EEG recording of brain wave activity.

130
Q

Lab studies used to identify epilepsy are:

5 items

A

WBCs, blood glucose, serum electrolytes, BUN, and Calcium.

131
Q

Which diagnostic procedures assist to verify Hydrocephalus?

A

Diagnostic Evals for Hydrocephalus:

  1. Serial measurements of Head Circumference (easy to do)
  2. CT
  3. MRI
  4. Lumbar Puncture
132
Q

When caring for a 4 year old girl, the nurse notes that her anterior fontanel is open and soft. This finding is:

A

abnormal for her age

133
Q

Schizencephaly is:

A

abnormal slits or clefts in the hemispheres of the brain.

Congenital brain malformation.

134
Q

Spina Bifida Occulta is:

A
  1. you get a dimple (dimples are good, right?!)
  2. section of SC is malformed
  3. Normal nerves AND SC
  4. occurs b/n L5-S1
  5. the lesser of all 3 evils (spina bifida types)
135
Q

Other clinical signs of Shaken Baby Syndrome:

6 items

A
  1. FTT (failure to thrive)
  2. Seizures
  3. Apnea
  4. Respiratory irregularities
  5. Vomitting associated with drowsiness or lethargy.
  6. Coma
136
Q

What are the 5 symptoms unique to Neonates experiencing Meningitis?

A
  1. Poor muscle tone, poor cry
  2. Apnea
  3. Hypothermia or hyperthermia
  4. Sepsis
  5. Disseminated intravascular coagulation

other symptoms:
Poor feeding/sucking, seizures, fullness/tense bulging fontanel, lethargy, vomiting.

137
Q

What are “sun-setting eyes” a symptom of?

A

Hydrocephalus

138
Q

Battle signs that must be reported to a physician are:

A

signs of double vision, and vomitting

139
Q

What is Persistent Vegetative state?

A

Complete unawareness of environment accompanied by sleep-wake cycles.
Most common cause is Hypoxic ischemic Encephalopathy (HiE)
NURSING CARE: sames as unconscious child

140
Q

Hydrocephalus is most often congenital and related to:

A

prematurity

tell that baby to stay in there!… until full term for sure

141
Q

Cerebral Palsy develops from:

A

brain injury occurring BEFORE Cerebral development is complete.

142
Q

Which type of meningitis resolves without treatment?

143
Q

Neuropathy symptoms are decreased ___________, pain, __________, problems with balance, __________ in the extremities.

A
  1. sensation
  2. tingling
  3. weakness
144
Q

What is key to being able to maximize a child’s abilities when it comes to Cerebral Palsy?

A

Early detection and
early intervention
plus a team approach.

145
Q

Cerebral Palsy is classified as:

5 in total

A 
Spastic,
Athetoid,
Ataxic,
Rigid,
Mixed
146
Q

What 2 physical things make up the CNS?

A
  1. Brain

2. Spinal Cord

147
Q

With or without treatment, this type of meningitis is fatal:

A

fungal meningitis.

148
Q

What medications is used to treat a headache?

2 kinds

A

ibuprofen

acetominophen

149
Q

Which cranial nerve innervates the structures necessary for hearing?

A

Cranial nerve 8

150
Q

In Gullain Barre Syndrome, there is rapid _____ weakness.

151
Q

What is another consideration for Pediatric Stroke?

A

Premie babies are more at risk,

MOMS: tell your baby stay inside until full term, if possible

152
Q

Pathophysiology of Reye Syndrome includes:

A
  1. causes Liver damage
  2. Leads to rising serum Ammonia levels

Rising ammonia levels leads to cerebral dysfunction, imbalances with fluid, electrolyte, acid-base and coagulopathies.

153
Q

Primary source that causes West Nile Virus is:

A

infected mosquitoes

154
Q

Decorticate is __________ positioning.

155
Q

Symptoms of Hydrocephalus in INFANTS are:

there are 6 signs

A
  1. Head SIZE increased rapidly (wicked unusual increase)
  2. Irritability
  3. Lethargy
  4. Seizures
  5. Sunsetting Eyes
  6. Vomitting
156
Q

Premature closure of sutures and fontanels can cause a potential for:

A

neurologic damage

157
Q

Near Drowning can be assessed using:

A

Orlowski’s scale

158
Q

After Surgery - Spina Bifida

list 3 nursing considerations

A
  1. Don’t secure diaper, just place it underneath infant.
  2. Measure: head circumference—why? it can tell you if Hydrocephalus is developing (hydro = water, cephal = head, us = structure, water in the head structure)
  3. Neurogenic Bladder. frequent, clean, straight catherization is preferred.

other Nursing considerations/interventions:

  1. Neurogenic Bowel: collaborate with family to develop plan, diet teaching, etc.
  2. Collaborate with Physical Therapist
  3. Teach child & family to re-position frequently, and INSPECT surgical area for signs of skin breakdown.
159
Q

What is the difference between tension headache and a migraine?

A

Tension headache is a steady pain, usually able to do activities.
Migraine headache is severe, disabling condition with throbbing, pounding, unilateral pain. Worsens with movement/exertion. Unable to continue with activities.

160
Q

What is Gower’s Sign?

A

Children in a squatting position have to use their hands and arms to “walk” up their bodies in order to stand up.
Weakness in the proximal muscles of the lower limbs.

161
Q

List 6 Nursing Assessment items for Head Injury of a child/infant:

A
  1. ABC’s
  2. Neck immobilization
  3. VS
  4. History and Neuro exam (eg. test cranial nerves)
  5. Glasgow Coma Scale
  6. Assess for alterations in antidiuretic hormone.
162
Q

What is Todd’s Paresis?

A

its the period after the seizure is over:
focal weakness in a part of the body after a seizure.
it is postictal paralysis that is temporary unilateral weakness, (*can be the entire side/half of the body)
Duration: 30 minutes to 36 hours
Occurs most often with: Generalize seizure & febrile seizure.
aka, Todd’s Palsy,

163
Q

Before fontanels fuse, an increase in ICP (intracranial pressure) causes an ________ in head ______________.

A

increase,
circumference.

Before fontanels fuse, an increase in ICP (intracranial pressure) causes an INCREASE in head CIRCUMFERENCE.

164
Q

Nursing considerations when a child has a seizure are:

3 items

A
  1. note if the mouth has any deviation to one side or the other, teeth clenching, bleeding, etc.
  2. observe for presence and length of apnea
  3. note duration of postictal period (altered state of consciousness after an epileptic seizure).
165
Q

At age 1, an infant’s brain is ___% of an adult’s brain size.

166
Q

Diagnosing Epilepsy with an EEG is also confirmed by a:

167
Q

It is a late sign of increased intracranial pressure

what is it called?

A

Cushing’s Triad

Cushing’s Triad is a late sign of ICP,
and it has 3 serious signs, plus you MUST notify Physician

168
Q

Nursing care of a Head Injury:

A
  1. Same as ICP, plus:
  2. No nasogastric suctioning with basilar skull fracture.
  3. Assess for fluid and electrolyte imbalance (due to possible problems with ADH).
169
Q

Migraine involves:

A

Aura, blurry or double vision, eye pain, photophobia.

170
Q

Seizures with no loss of consciousness are:

A

partial seizures, or FOCAL seizures

171
Q

What are the 3 symptoms unique to Infants experiencing Meningitis?

A
  1. Fever
  2. Irritability
  3. High-pitched Cry

other symptoms:
Poor feeding, seizures, bulging anterior fontanel, lethargy, vomiting.

172
Q

A minor head injury involves:

A

possible changes in LOC, transient periods of confusion, irritable, vomiting, somnolence and headache.

173
Q

MicroEncephaly is:

A

circumference of the head is more than 2 standard deviations below normal.

Congenital brain malformation.

174
Q

Seizures have a primary and a secondary cause, what is the difference?

A

Primary cause of seizure: absence of any underlying injury.

Secondary cause is provoked by a temporary or permanent structural, or, metabolic disorder.

175
Q

Which type of meningitis is fatal if left untreated?

176
Q

Anencephaly is:

A

most of the brain does NOT develop

prefix: an= without; not
Root word: encphal/o = brain
suffix: y= condition; process
scary, without brain!

177
Q

What is the analogy used to describe a tension headache in children?

A

it’s like a rubber band around the head.

178
Q

What nursing intervention is important to promote for a child with epilepsy?

A

Promoting development of a positive self-image for the child.

179
Q

Name 5 medications used to treat Reye Syndrome.

A
  1. Corticosteriods
  2. Mannitol
  3. Barbiturates (if cerebral edema is severe)
  4. Phenytoin (to control seizures)
  5. Vitamin K (to aid coagulation)
180
Q

The education of the child with migraines, (and their family) includes:

A

learning stress management

avoidance of headache triggers

181
Q

List 6 categories of head injuries.

A

Closed, open,

coup, contrecoup injury, missile, impalement.

182
Q

Which diagnostic tests help rule out a brain tumor and gets you closer to a diagnosis of Cerebral Palsy?

A

Diagnostic tests include:

  1. Serum electrolytes
  2. Computed Tomography
  3. MRI
183
Q

Status Epilepticus is a:

A

pediatric emergency.

184
Q

List 5 Nursing Interventions for Reye Syndrome

A
  1. Care is focused on support of child’s physical status
  2. Monitor: cerebral edema, I&O, VS, Lab values
  3. Perform ongoing neurological assessments
  4. Prevent complications of immobility
  5. Provided emotional support to family
185
Q

Identify 4 Nursing Interventions/considerations for a child/infant with Cerebral Palsy.

A
  1. Increase calorie intake
  2. Seizure precautions
  3. Safety (due to poor coordination)
  4. Communication board (to help child “talk” to you)
186
Q

Hydrocephalus in infants is most often:

A

congenital (born with it) or associated with prematurity.

Note: there is also acquired and etiology unknown

187
Q

List 6 assessment items for Spinal Cord Injury.

A
  1. Spine must be immobilized
  2. Airway assessed immediately
  3. Circulation
  4. Shock
  5. Neurologic assessment
  6. Trauma to other systems
188
Q

Grand mal seizures are:

A

generalized seizures

189
Q

When does a Pediatric Stroke occur?

there are 4 different situations, in which PS can occur

A
  1. in UTERO.
    what!???
  2. even worse, can occur during birth, or
  3. shortly after birth.
  4. can occur as a result of TRAUMA, or ILLNESS, or sickle cell disease.
190
Q

A diagnosis of Hydrocephalus is bad enough and to make things worse, it is has a buddy. What is the tag-along with Hydrocephalus?

A

Myelomeningocele.

Hydrocephalus, is often associated with Myelomeningocele.

191
Q

What type of bed can you use for a child with ICP?

A

pressure equalizing mattress.

(very fancy and expensive mattress i might add).

192
Q

Spinal shock can last __ weeks or more.

A

three weeks

193
Q

What is thought to be the cause of neural tube defects?

A

Folic Acid Deficiency

194
Q

Identify 4 goals a nurse must consider when it comes to teaching parents on the care of a child with Cerebral Palsy.

A
  1. Coping with muscular impairment
  2. Using DME, such as splints, braces or assistive equipment.
  3. Safety! Safety! Safety!
  4. Working with the school (school age child)
195
Q

A 16 year old girl loses consciousness, falls to the floor, and begins jerking her arms and legs. As the school nurse, you know that she is having a seizure. What DONT you do?

A

put a padded spoon in her mouth to keep her from biting her tongue

196
Q

Which medications help control prolonged seizures?

A

Lorazepam (ativan)

Diazepam (valium)

197
Q

At what age does the Posterior Fontanel close?

At what age does the Anterior Fontanel close?

A

Posterior Fontanel closes at 2 months old

Anterior Fontanel closes at 18 months old

198
Q

Craniosynstosis is:

A

premature closure of the sutures of the infant’s head, resulting in abnormal head shape.

Congenital brain malformation.

199
Q

Tourette’s Syndrome is:

A

both motor and vocal tics are present.
MUST have started before the 18th birthday.
MUST have been present for more than 1 year.

200
Q

Which nerves are NOT myelinated at birth?

A

Peripheral nerves

201
Q

List 4 differences in the CNS for pediatrics.

A
  1. Nervous System is NOT mature at birth
  2. Brain is 12% of weight for Newborn
  3. Brain is highly vascular
  4. Dura can strip away from PeriCranium.
202
Q

Moderate or severe head injury involves:

A

altered mental status, changes in VS, signs of increased ICP, retinal hemmorhage, hemiparesis and papilledema.

203
Q

How does child obesity affect sleep?

A

May cause obstructive sleep disorder and sleep apnea.

204
Q

List the 5 stages of Reye Syndrome:

A
  1. vomiting, lethargy
  2. combativeness, confusion
  3. Coma, decorticate posturing
  4. Decerebrate posturing
  5. Seizures, loss of deep tendon reflexes, respiratory arrest

Holistic Maternal and Child Nursing: Pediatrics (7 decks)

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