Module 5 Neurological

Question 1

What are the main differences in the nervous system between children and adults?

Answer 1

Infants have an immature nervous system, unfused sutures, and myelination continues until the first year​

Question 2

What is the normal infant head circumference at birth?

Answer 2

34-35 cm; increases to 47 cm by 1 year​

Question 3

What are the early signs of increased intracranial pressure (ICP) in infants?

Answer 3

Irritability, high-pitched cry, bulging fontanels, separated sutures, and “sunset” eyes​

Question 4

What are the late signs of increased ICP?

Answer 4

Bradycardia, wide pulse pressure, altered pupils, papilledema, Cheyne-Stokes respirations, and coma​

Question 5

Describe the Glasgow Coma Scale (GCS) scoring.

Answer 5

Score 15: normal LOC
Score less than or equal to 8:
Score 3: severe brain injury​

Question 6

What is Cushing’s triad in ICP?

Answer 6

Bradycardia, wide pulse pressure, and increased systolic BP​

Question 7

How does a head injury occur in children?

Answer 7

Falls, motor vehicle accidents, and bicycle injuries​

Question 8

What are the types of skull fractures in children?

Answer 8

Linear, depressed, comminuted, basilar, open, and growing fractures​

Question 9

What are common complications of head trauma?

Answer 9

Epidural hemorrhage, subdural hemorrhage, and cerebral edema​

Question 10

What is bacterial meningitis, and how is it transmitted?

Answer 10

Acute inflammation of meninges caused by bacteria, transmitted through respiratory droplets​

Question 11

What are the key signs of meningitis in children?

Answer 11

Fever, headache, nuchal rigidity, vomiting, photophobia, and rash​

Question 12

What are Kernig’s and Brudzinski’s signs?

Answer 12

Kernig’s: leg pain when extended
Brudzinski’s: neck flexion causes knee/hip flexion

Question 13

What is encephalitis?

Answer 13

Inflammation of the brain and spinal cord, often viral, causing fever, headache, and altered LOC​

Question 14

Describe Reye’s syndrome.

Answer 14

Toxic encephalopathy with liver dysfunction, associated with aspirin use in viral infections​

Question 15

What is epilepsy?

Answer 15

Two or more unprovoked seizures due to abnormal brain electrical activity​

Question 16

What are tonic-clonic seizures?

Answer 16

Seizures with muscle stiffening (tonic) and jerking (clonic) phases, loss of consciousness​

Question 17

What are absence seizures?

Answer 17

Brief loss of consciousness, common in children aged 4-12, often mistaken for daydreaming​

Question 18

What are febrile seizures?

Answer 18

Seizures in children aged 6-60 months, triggered by fever, often benign​

Question 19

How is hydrocephalus caused?

Answer 19

Imbalance between CSF production and absorption, leading to increased ventricular pressure​

Question 20

What is the main treatment for hydrocephalus?

Answer 20

Ventriculoperitoneal (VP) shunt to drain excess CSF​

Question 21

What are the symptoms of shunt infection in hydrocephalus?

Answer 21

Fever, irritability, vomiting, headache, and seizures​

Question 22

What is a neuroblastoma?

Answer 22

Malignant extracranial tumor, often in the adrenal gland or sympathetic chain​

Question 23

What are common brain tumor symptoms in children?

Answer 23

Headache, vomiting, balance issues, and vision changes​

Question 24

What diagnostic tests are used for brain tumors?

Answer 24

MRI, CT scan, and lumbar puncture​

Question 25

What is submersion injury?

Answer 25

Injury from near-drowning, leading to hypoxia, asphyxiation, and aspiration​

Question 26

What is the primary concern in respiratory management of unconscious children?

Answer 26

Maintaining airway to prevent cerebral hypoxia​

Question 27

What medications are used for managing increased ICP?

Answer 27

Mannitol (osmotic diuretic), corticosteroids, and sedatives​

Question 28

What is the ketogenic diet used for?

Answer 28

Controlling seizures in children with epilepsy by promoting ketosis​

Question 29

What are the phases of post-traumatic brain injury syndromes?

Answer 29

Postconcussion syndrome, post-traumatic seizures, and hydrocephalus

Question 30

How can positional plagiocephaly be prevented?

Answer 30

Tummy time, alternating head position during sleep, and supervised prone positioning​

Question 31

What are the main types of seizures based on onset?

Answer 31

Partial (localized), generalized (both hemispheres), and unclassified​

Question 32

What is myoclonic seizure?

Answer 32

Sudden, brief muscle contractions that can be single or repetitive, with or without consciousness loss​

Question 33

What are infantile spasms?

Answer 33

Seizures in infants aged 6-8 months with poor prognosis for normal intelligence​

Question 34

What causes nonbacterial (aseptic) meningitis?

Answer 34

Principally viruses, such as enteroviruses, with symptoms of headache, fever, and nuchal rigidity​

Question 35

What is the pathophysiology of submersion injuries?

Answer 35

Hypoxia, asphyxiation, aspiration, and hypothermia leading to cardiac arrest and CNS damage​

Question 36

What are the complications of subdural and epidural hematomas?

Answer 36

Increased ICP, brain herniation, and possible death if not treated promptly​

Question 37

What are the typical signs of encephalitis?

Answer 37

Sudden fever, headache, stiff neck, altered mental status, and possibly seizures​

Question 38

How is pain managed in comatose children?

Answer 38

Use opioids like morphine cautiously, monitor vitals, and maintain a calm environment​

Question 39

What is the nursing care focus for children with brain tumors?

Answer 39

Preoperative education, body image concerns, and postoperative recovery support​

Question 40

What is positional plagiocephaly?

Answer 40

Cranial asymmetry from prolonged supine positioning; managed by repositioning and tummy time​

Question 41

What is the typical treatment approach for bacterial meningitis?

Answer 41

Isolation, antibiotics, ICP control, and seizure management​

Question 42

What is the role of the Pediatric Glasgow Coma Scale (GCS)?

Answer 42

To assess eye, verbal, and motor responses; score ≤8 indicates coma​

Question 43

How do neuroblastomas typically present?

Answer 43

Silent tumors often metastasized at diagnosis, primarily in the adrenal gland or sympathetic chain​