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Nursing 3800: Pediatrics > Exam 2: Neurologic Disorders > Flashcards

Exam 2: Neurologic Disorders Flashcards

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1
Q

When in neural tube development?

A

first 3 to 4 wks gestation

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2
Q

Why is a babies brain at an increased risk for hemorrhage?

A

bc it is highly vascular

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3
Q

A child is at high risk for cervical spine injury why?

A

Spinal cord is mobile

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4
Q

True of False in a child’s neurological system their myelination isn’t complete.

A

true

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5
Q

What is hypotonia and who is it often seen in?

A

decreased muscle tone; down syndrome.

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6
Q

What is trauma or hypoxia to the brain or spinal cord known as?

A

neurologic insult

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7
Q

name the state of consciousness: limited responses to the environment, falls asleep unless stimulation is provided.

A

obtunded

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8
Q

name the state of consciousness: child cannot be aroused, even with painful stimuli

A

coma

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9
Q

name the state of consciousness: awake, alert, oriented x3, age appropriate behaviors.

A

full consciousness

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10
Q

name the state of consciousness: only responds to vigorous stimulation.

A

stupor

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11
Q

name the state of consciousness: disorientation exists, alert but responds inappropriately to questions.

A

confusion

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12
Q

what are the three categories of the Glasgow coma scale? what is it used for?

A

eye, verbal, motor responses; to define child’s LOC

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13
Q

Fluoroscopy and cerebral angiography are both used to ?

A

look at blood flow in the brain

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14
Q

True or False if patient is heavily sedated EEG are unless.

A

true

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15
Q

What position should a patient receiving a lumbar puncture be placed in?

A

side-lying, with legs pulled up and head bent down onto the chest.

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16
Q

What are some common meds to treat neuro disorders?

A

antibiotics, anticonvulsants, benzodiazepines, analgesics, osmotic diuretics, corticosteroids.

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17
Q

What are ketogenic diets?

A

high protein, low carb

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18
Q

When observing pts with neurological disorders what is the first thing we look for?

A

change in LOC

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19
Q

What are some early signs of increased ICP?

A

HA, vomiting, dizziness, blurred vision, decreased pulse and respirations, increased blood pressure, sunset eyes(can see white above pupils and iris), seizure. infant: bulging fontanels, wide sutures, high-pitched cry

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20
Q

What are some late signs of increased ICP?

A

decreased LOC, decreased motor and sensory responses, bradycardia, irregular respirations, cheyne-strokes respirations, decerebrate or decorticate positioning

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21
Q

What is hydrocephaly? what are the two classes?

A

diseases/disorders that cause an imbalance in the production and the absorption of CSF; obstructive/ non-communicating or non-obstructive/ communicating

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22
Q

What is obstructive hydrocephaly?

A

flow of CSF is blocked within the ventricular system

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23
Q

What is non-obstructive hydrocephaly?

A

flow of CSF is blocked after it exists from the ventricles.

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24
Q

What are some causes of obstructive vs non-obstructive?

A

meningitis, trauma, tumors; defective absorption of CSF, subarchnoid hemorrhage, intrauterine infections

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25
Q

What type of posture occurs with damage to the cerebral cortex?

A

decorticate

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26
Q

What type of posture occurs with damage at the level of the brain stem?

A

decerebrate

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27
Q

true or false decorticate is extension posturing.

A

false: flexion

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28
Q

true or false: in both types of posturing rigid muscle tone occurs.

A

true

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29
Q

When do you teach at an 8th grade level?

A

Consent or medical handbook

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30
Q

When do you teach to the patients level?

A

during clinical teaching

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31
Q

What are some risk factors for seizures?

A

family hx of epilepsy, any prenatal complications, delays in development, any recent illness, trauma, or toxin exposure.

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32
Q

What is the most common type of seizure?

A

tonic-clonic

33
Q

What type of seizure is: generalized lasting < 15 mins, occurring once in 24 hours, & accompanied by fever without any CNS infection?

A

febrile seizures

34
Q

what are some characteristics of febrile seizures?

A

most common childhood seizure disorder, peaks 12-18 months, most common in boys, core temp 102.2

35
Q

During febrile seizure what to do give child?

A

rectal diazepam

36
Q

when are neonatal seizures common?

A

first four wks of life generally but most common in first 10 days of life.

37
Q

True or false ocular deviation maybe seen with neonatal seizures.

A

true

38
Q

true or false: tonic-clonic seizures can occur within the first 4 wks of life.

A

false

39
Q

What is a neonates response to stress?

A

stop breathing

40
Q

What is the med of choice for neonate seizures?

A

phenobarbital

41
Q

What is important in management of neonatal seizures?

A

adequate ventilation

42
Q

What is vertebral bodies without protrusion of the spinal cord or meninges? what would u see in assessment?

A

spinal bifida occulta; normal variant, noticeable dimpling or patch of hair or discoloration of skin.

43
Q

What is less serious then SB cystica occur when meninges herniate through defect in the vertebrae.

A

meningocele: skin over sac is intact

44
Q

What is the most serious form and the spinal cord often ends at the point of the defect?

A

myelomeningocele

45
Q

True or false: your bladder requires nerves.

A

true

46
Q

true or false: decerebrate posturing is rigid extension and pronation of the arms and legs, rigid muscle tone overall.

A

true

47
Q

What type of meds improve bladder capacity?

A

oxybutynin chloride (Ditropan)

48
Q

What is a small or missing brain/skull/scalp called?

A

anencephaly

49
Q

What is a protrusion of the brain and meninges through a skull defect know as?

A

encephalocele

50
Q

what is it called when the head circumference is greater than 3 standard deviations below mean for age and gender of infant?

A

microcephaly

51
Q

Patient has ICP, which of the following are trends in vitals?

A

increasing temp, decreasing pulse & respirations, increasing blood pressure.

52
Q

True or false: Type two Arnold-chiari malformation is associated with hydrocephalus and myelomeningocele.

A

True(obstruction of CSF)

53
Q

What are symptoms of type 1 Arnold-chiari malformation?

A

neck pain, recurrent HA, lower extremity spasticity, & urinary frequency.

54
Q

True or false: type 2 Arnold-chiari malformation infants have weak cry, stridor, & apnea, aspiration, gagging, prolonged feeding times, & weight loss.

A

true

55
Q

True or false: intracranial arteriovenous malformation has a possibility of hemorrhage.

A

true

56
Q

What is premature closure of the cranial sutures known as?

A

craniosynostosis

57
Q

What is a condition with clinical symptoms characterized by abnormal motor patterns and postures caused by nonprogressive abnormal brain function?

A

cerebral palsy: most common neurologic disease

58
Q

What are some important factors in post op care for craniosynostosis patients?

A

H&H and blood loss, prevent infection, comfort measures.

59
Q

For plagiocephaly it is important to assess patients neck for?

A

torticollis

60
Q

name the two classifications of cerebral palsy:
present after forced dorisiflexion. CP infants demonstrate a prolonged standing on their toes when supported in an upright position.

increased resistance to dorsiflexion and passive hip abduction.

A

clonus;

hypertonicity

61
Q

What type of CP is being described:

hypertonicity, permanent contractures, most common form, poor posture, balance, movement.

A

spastic

62
Q

What type of CP is being described:
abnormal involuntary movements, slow worm like movements, affect all four extremeties, face/neck/tongue,
increase movements with stress.

A

athetoid or dyskinetic

63
Q

What type of CP is being described:

affects balance & depth perception, rare form, poor coordination

A

ataxic

64
Q

What are the two most common mixed CP?

A

spastic and athetoid.

65
Q

What three therapies are important for CP?

A

physical, speech, occupational

66
Q

What are the common causes of head trauma in children?

A

falls, motor vehicles accidents, bicycle accidents, child abuse.

67
Q

What are the causes of non-accidental head trauma?

A

SBS, blows to head, banging head on wall, floor, etc

68
Q

What are some risk factors for birth trauma?

A

multiple deliveries, LGA, infants w. extreme prematurity, Infants with big heads and congenital anomalies.

69
Q

What are some signs of cerebral vascular disorders?

A

weakness on one side or hemiplegia, facial droop, slurred speech.

70
Q

What is the most common reason why children miss school?

A

HA

71
Q

What is a common behavior of 1-3 yr olds in response to stress?

A

breath holding.

72
Q

What disorder affects the spinal nerves ability to communicate with the muscles?

A

Spinal Muscular Atrophy

73
Q

True or false: in SMA distal muscles are affected more than proximal muscles.

A

false: proximal are affected more.

74
Q

true or false in SMA emotional, mental development, and sensation are unaffected.

A

true

75
Q

What lab test do you do in SMA?

A

Creatine kinase, genetic testing, muscle biopsy.

76
Q

When do you do surgery for scoliosis patients?

A

when breathing is affected.

77
Q

What test would you do to detect neural tube defect in fetus?

A

ultrasound

78
Q

What is the most common movement disorder of childhood?

A

CP

79
Q

true or false: tonic seizures are rare in neonatal period.

A

false: myoclonic

Nursing 3800: Pediatrics (14 decks)

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