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Dressler 3rd Semester > Module 4 Care of the child with Neurological disorders > Flashcards

Module 4 Care of the child with Neurological disorders Flashcards

1
Q

The higher the injury is to the brain, the more

A

symptoms

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2
Q

In the Glasgow scale a 9-10 means

A

light coma

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3
Q

In the Glasgow scale a 6,7,8 score means

A

deep coma

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4
Q

under 3 in the glasgow scale means child is

A

totally unresponsive

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5
Q

for a child that has just sustained a head injury it is important for them not to

A

go to sleep

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6
Q

5 S&S of Increased Intracranial Pressure

A 
Lethargy 
Shrill cry 
Poor muscle tone 
Seizures 
Poor appetite
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7
Q

What is the tx for Hydrocephalus

A

VP shunt

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8
Q

How does a VP shunt work

A

fluid goes from head to abdomen for liver to absorb so it can go back into circulation

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9
Q

Children with VP shunts have a tendency to be

A

unbalanced

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10
Q

In a child with a VP shunt how should you position them

A

un-operative side

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11
Q

Congenital embryonic neural tube defect - imperfect closure of spinal vertebrae

A

Spina Bifida

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12
Q

What decreases incidence of Spina Bifida?

A

Folic acid

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13
Q

Define Spina Bifida occulta and it’s manifestations

A

Minor variation - opening in spinal column small & no protrusion of structures

Tuft of hair or small dimple

Occurs at L5 or S1

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14
Q

Non congenital defect causing muscle weakness due to lack of oxygen at birth

A

Cerebral palsy

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15
Q

What actions are affected in cerebral palsy?

A

Impaired movement
Delayed milestones
Difficulty feeding

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16
Q

Type of CP that has slow and snake-like movement

A

Athetoid

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17
Q

Type of CP that shows no coordination

A

Ataxic

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18
Q

Type of CP where muscles don’t contract

A

Rigidity

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19
Q

Combination of other CP’s

A

Mixed

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20
Q

Altered neurological impulse causing rapid muscle contraction

A

Seizure

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21
Q

What can cause a seizure

A

Unknown
Fever
Trauma
Brain tumor

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22
Q

How long do seizures last and what can happen during and after a seizure has occurred?

A

30-90 seconds
Person becomes incontinent of urine
Person develops amnesia of the seizure event

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23
Q

Another name is tonic-clonic seizure

A

Gran-Mal

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24
Q

What causes Reye’s syndrome?

A

Viral infection

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25
Q

How does Reye’s syndrome present itself?

A 
Vomiting 
Sluggish behavior
Lethargic
Seizures
Stroke like symptoms
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26
Q

Inflammation of the meninges - meningitis can be caused by

A

A virus or a bacteria

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27
Q

What kind of isolation is used for meningitis and when is isolation constituted

A

Respiratory isolation and only if there’s + brudzinski sign

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28
Q

What decreases the risk of developing meningitis?

A

HIB vaccine

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29
Q

Signs and symptoms of meningitis

A

Severe headache, stiff neck (nuchal rigidity) irritability, fever, restlessness, petechia, vomiting & + brudzinski sign (when you put chin into chest, knees goes up involuntarily)

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30
Q

What is a lumbar puncture

A

Small amount of cerebral

Spinal fluid is extracted

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31
Q

What color should CSF be

A

Clear

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32
Q

What is encephalitis

A

Inflammation of the brain usually caused by a virus

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33
Q

What adverse effect is common if encephalitis is left untreated or undiagnosed?

A

Deafness

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34
Q

Positioning for lumbar puncture

A

Place child in lateral position
Hold neck and thighs to
Make a curve in the spine
Talk quietly to child for reassurance

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35
Q

Signs and symptoms of a head injury such as a concussion or a skull fracture

A

Increased ICP
Headache
Hypoxia
Change in LOC

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36
Q

Why do we not medicate for pain in head injuries

A

We do not want to mask symptoms. Symptoms tell us if condition is worsening

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37
Q

Describe decerbrate positioning in head injuries

A

Supine hands flexed back

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38
Q

Describe decorticate positioning in head injuries

A

Arms wrist and fingers flexed up

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39
Q

What is a neuroblastoma

A

Malignant tumor in the adrenal gland

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40
Q

When abdomen in palpated in neuroblastoma what will be found

A

Abdominal mass

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41
Q

Signs and symptoms of neuroblastoma

A

Abdominal mass
HTN
Tachycardia
Respiratory depression

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42
Q

Why is the prognosis poor in neuroblastoma

A

Metastasis of the tumor occurs before it is even discovered

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43
Q

Mental retardation - Intellectual disability/impairment definition

A

Below average mental functioning

Onset before 18 years old

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44
Q

Signs and symptoms of MR

A

Deficit in adaptive behavior

Affects memory mood and language

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45
Q

Treatment for MR

A

Early intervention
Emphasize strengths
Family support
AHRC

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46
Q

What is Down’s syndrome

A

Mild to severe form of MR

47
Q

Characteristics of Down’s syndrome

A 
Small head 
Round face
Flat nose
Protruding tongue
Close set eyes
Simian crease
Short thick hands 
Congenital heart defects
48
Q

Diagnosis of Spina Bifida pre natal

A

Alfa-fetal protein level at 13-15 weeks

Amniocentesis if indicated

49
Q

What is one thing we must not let kid do after a head injury

A

Go to sleep

50
Q

What does the b/p and the p do with increased ICP

A

B/p goes up and pulse goes down

51
Q

If kid has bulging fontanels what position should we put them in and if they had sunken fontanels what position should we put them in

A 
Bulging = sit them up 
Sunken = lay them down
52
Q

Increased AFP shows suspicion of what

A

Spina Bifida

53
Q

Spontaneous abortion or preterm birth can cause

A

amniocentesis

54
Q

When should surgery be done for myelomeningocele

A

within 24-48 hrs

55
Q

What can we do to repair damage the spinal cord

A

no fix for spinal cord yet

56
Q

Which reflex is absent in myelomeningocele

A

babinsky reflex

57
Q

Post op Spina bifida how should child be positioned

A

head slightly elevated

58
Q

Shill cry could mean

A

increased ICP

59
Q

what are two complications of post spina bifida surgery

A

chronic constipation

stool leakage

60
Q

In cerebral palsy what is also affected as a result of lack of OXYGEN

A

muscle function

61
Q

Spastic Cerebral Palsy is

A

Twitching

62
Q

Adenoid Cerebral Palsy is

A

slow snake like movement

63
Q

Ataxic Cerebral Palsy is

A

Lack of muscle control

64
Q

Rigidity Cerebral Palsy is

A

unable to move muscles

65
Q

Why do we perform ROM in Cerebral Palsy

A

to prevent contractions

66
Q

Which population of kids are prone to seizures

A

Hydrocephalus

67
Q

Head trauma, Rapid rise in Temp, Pressure in brain can cause a

A

Seizure

68
Q

How long do seizures usually last

A

30-90 seconds

69
Q

Not all seizures cause _______ however all _______ causes seizures

A

epilepsy

70
Q

When do kids usually outgrow febrile fevers

A

By age 3

71
Q

Infertile spasms usually are in _______ kids. They can have an overactive Moro which means they are _______

A

Myoclonic, they are jumpy

72
Q

When giving anti-convulsants to kids it is important to tell parents that the drugs can cause

A

drowsiness

73
Q

Reyes syndrome is linked to which drug use

A

aspirin

74
Q

HIB vaccine for meningitis decreases risk for

A

Reyes syndrome

75
Q

In reyes syndrome because of STROKE LIKE SYMPTOMS kid has increased risk for

A

bleeding in brain

76
Q

HIM (Meningitis) which isolation do we place kid on

A

Resp isolation

77
Q

A common symptom of meningitis is Nuchal head which is

A

stiff neck cant even pick it up

78
Q

Which sign is specific to meningitis

A

Brudzinski sign

79
Q

If lifting a child by the head and the child’s leg/knee comes up that is a positive sign of

A

Meningitis

80
Q

What is a major risk when doing lumbar puncture

A

Paralysis / Spinal damage

81
Q

Before lumbar puncture what is needed

A

informed consent

82
Q

For lumbar puncture how do we treat parents

A

dont let them know whats going on, dont keep them in room. dont sedate child we need them with full LOC

83
Q

What do we look for post meningitis / lumbar puncture

A

leakage

84
Q

post meningitis / lumbar puncture child will be on resp isolation for how long

A

24-72 hours

85
Q

encephalitis is usually caused by

A

Mosquito (West nile virus)

86
Q

By the time we diagnose Nephroblastoma we have to tell parents what

A

prognosis is poor and it has already metastasized, child may not survive

87
Q

What can a distended abdomen mean

A

malfunction in VP shunt

88
Q

Spaces in the bones is referred to as

A

Spina bifida

89
Q

Occulta is

A

Spina bifida

90
Q

Post incontinence, or passing of urine can happen immediately after what

A

seizure episode

91
Q

Persistent vomiting happens in what

A

Reyes Syndrome

92
Q

Liver dysfunction can lead to

A

increased ammonia

93
Q

What is a positive Brudzinski’s sign

A

Push head to chest, if legs come up on their own + sign

94
Q

We elevate HOB for which condition

A

Hydrocephalus

95
Q

We place child prone or side lying for which condition

A

Spina Bifida

96
Q

A child with hydrocephalus has increased blood pressure, decreased pulse rate, and decreased respirations. The nurse suspects these symptoms indicate

A

Increased ICP

97
Q

Infants with spina bifida commonly have an allergy to:

A

Latex

98
Q

a protrusion of the membranes and cord through an opening in the spine

A

Meningomyelocele

99
Q

Motor disability caused by a nonprogressive disturbance in brain development

A

Cerebral palsy

100
Q

Complication that affects the liver and brain

A

Reyes syndrome

101
Q

A practice that has helped us prevent mental retardation is

A

blood test at birth

102
Q

Seizure where child cries out, falls on the floor, becomes rigid, and then has a convulsion

A

Grand-mal

103
Q

he development of Reye’s syndrome has been associated with the use of aspirin while infected with

A

Meningitis

104
Q

Which is not a characteristic of brain tumors in children

A

Decreased BP

105
Q

Which is the most useful diagnostic procedure in diagnosing a seizure disorder

A

Electroencephalography

106
Q

presence of blood in the anterior chamber of the eye

A

Hyphema

107
Q

What 2 symptoms are early signs of Reyes syndrome

A

Vomiting and lethargy

108
Q

Encephalitis can be secondary to what

A

Respiratory infection

109
Q

two symptoms of meningitis

A

fever and irritability

110
Q

inability to arouse the child is an early sign of

A

Increased ICP

111
Q

Before surgical repair what position should you place the child in for Meningomyelocele

A

Prone, maintaining abduction with a pad between legs

112
Q

Whens the best time to do EEG

A

When child is sleeping

113
Q

Best diet for Seizures

A

Ketogenic diet (high fat low carb)

114
Q

What is a spica cast

A

Cast from chest to lower extremities

Dressler 3rd Semester (7 decks)

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