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OB/PED Level 3 Exam 4 > Child with Neurologic Alteration > Flashcards

Child with Neurologic Alteration Flashcards

1
Q

CNS is composed of ________

A

brain and spinal cord

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2
Q

Myelinization of the nerves begins in the ____ of gestation and is completed by ________.

A

3rd month; adolescence

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3
Q

Brain and spinal cord are covered by the _______.

A

meninges

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4
Q

CSF surrounds the _____ and ________.

A

brain and spinal cord

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5
Q

Brain consists of three sections

A

cerebrum, cerebellum and brainstem

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6
Q

There are _______ pairs of never

A

12

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7
Q

Testing of the cranial nerves can indicate ______ and _____ of CNS injury

A

location and degree

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8
Q

Auto regulation is also known as ______.

This process allows ______ to change in diameter in response to changes in _____ ______ ______.

A

self-regulation; cerebral arteries ; cerebral perfusion pressure.

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9
Q

auto regulation can be impaired by _____,______,_____.

A

trauma , ischemia and ICP

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10
Q

What is increased intracranial pressure (IICP)

A

Results in disturbance in the auto-regulation of the pressure exerted by the blood, brain, CSF, and other space-occupying fluid/mass within the CNS

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11
Q

ICP is defined as pressure sustained at _____mm hg or ____ for _____ minutes or longer

A

20; higher ; 5

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12
Q

What causes IICP?
_______ or ______ of CSF
Space occupying ____-_____,______

A

overproduction or malabsorption;
lesion-tumor, hematoma ;

infection and head trauma

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13
Q

Manifestations of IICP in infant are?

A 
poor feeding or vomiting, 
irritability, restlessness or lethargy
bulging fontanel**
high-pitched cry
Increased head circumference**
separation of cranial sutures***
distended scalp veins
eyes deviated downward ***late sign
increased or decreased sings to pain ***
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14
Q

IICP manifestations for child are ?

A 
Headache
diplopia
mood swings 
slurred speech
papilledema - after 48 hours 
altered LOC
N/V especially in the AM
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15
Q

Neuro Examination

GCS assesses ___,____,____

A

eye opening, verbal response and motor response.

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16
Q

GCS ranges from ___ to ____

A

15 to 3

17
Q

GCS of 15 indicates

A

no change in LOC

18
Q

a GCS of 3 indicates

A

deep coma and poor prognosis

19
Q

Neuro Exam - Behavior such as _______

A

parent’s reporting child isn’t acting like himself

20
Q

Neuro Exam - decreased response to _____ stimuli is a significant sign of alteration in level of consciousness

A

painful

21
Q

Neuro Exam- pupil eval

Compression of the ____ cranial nerve, results in pupil _____ with _____ or ____ constriction

A

3rd
dilation
sluggish or absent

22
Q

Neuro Exam- Pupil Eval
a fixed _____ pupil is an ominous sign of an ____ child
other signs include ____ and ______

A

dilated ; unconscious

ptosis ; ovoid pupil

23
Q

Neuro exam Motor Function
A child with increased ICP exhibits changes in motor function. _______ movement will decrease and ____ posturing may be observed

A

purposeful ;abnormal

24
Q

Neuro exam - motor function
Flexion also known as
Plantar ______

A

decorticate posturing
** hug the upper extremities and extension of the lower extremities
flexion

25
Q

NE- motor function
extension or ______
extension of the upper extremities with _____ rotation
lower extremities will ____ with _____ rotation
a change from flexion to extension indicates

A

decerebrate posturing
internal of the upper arm and wrist
extend with internal of kneed and feet
deterioration

26
Q

Vital- neuro exam
Cushing response
_______ systolic BP with _____ pulse pressure
_____cardia and a change in _______ rate and pattern.
this is usually present just _____ or at the time of brain stem herniation.
The body is trying to ______

A

increased;widened
brady; respiration;

before

compensate
this is a late sign

27
Q

Standard terms for LOC

Full consciousness

A

awake, alert, oriented, interacts with environment

28
Q

Confused

A

lacks ability to think clearly and rapidly

29
Q

delirous

A

impairment of reality with hallucination possible

30
Q

disoriented

A

lacks ability to recognize place or time or person

31
Q

obtunded

A

sleeps and once aroused has limited interaction with environment

32
Q

stupor- requires ____ to arouse

A

requires stimulation to arouse

33
Q

Coma vigorous stimulation produces no _____

A

response

34
Q

in child with ICP avoid ____ and position _____ with HOB elevated to ____ degrees
closely monitor for ____ levels

A

stimulation ; midline;30

glucose

35
Q

fluid for ICP

A

NS with child with hypovolemia and osmotic diuretic (mannitol or hypertonic saline , sedation and analgesia and anticonvulsant meds. hyperventilation if there is signs of cerebral herniation

36
Q

Spina bifida is a ______

classified as _____ closure of the _____

A

congenital NTD

incomplete closure of the vertebrae

37
Q

Spina bifida occulta

spina bifida cystica

A

closed in lower lumbar area

OB/PED Level 3 Exam 4 (2 decks)

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