Module 5 Neurological Flashcards
What are the main differences in the nervous system between children and adults?
Infants have an immature nervous system, unfused sutures, and myelination continues until the first year
What is the normal infant head circumference at birth?
34-35 cm; increases to 47 cm by 1 year
What are the early signs of increased intracranial pressure (ICP) in infants?
Irritability, high-pitched cry, bulging fontanels, separated sutures, and “sunset” eyes
What are the late signs of increased ICP?
Bradycardia, wide pulse pressure, altered pupils, papilledema, Cheyne-Stokes respirations, and coma
Describe the Glasgow Coma Scale (GCS) scoring.
Score 15: normal LOC
Score less than or equal to 8:
Score 3: severe brain injury
What is Cushing’s triad in ICP?
Bradycardia, wide pulse pressure, and increased systolic BP
How does a head injury occur in children?
Falls, motor vehicle accidents, and bicycle injuries
What are the types of skull fractures in children?
Linear, depressed, comminuted, basilar, open, and growing fractures
What are common complications of head trauma?
Epidural hemorrhage, subdural hemorrhage, and cerebral edema
What is bacterial meningitis, and how is it transmitted?
Acute inflammation of meninges caused by bacteria, transmitted through respiratory droplets
What are the key signs of meningitis in children?
Fever, headache, nuchal rigidity, vomiting, photophobia, and rash
What are Kernig’s and Brudzinski’s signs?
Kernig’s: leg pain when extended
Brudzinski’s: neck flexion causes knee/hip flexion
What is encephalitis?
Inflammation of the brain and spinal cord, often viral, causing fever, headache, and altered LOC
Describe Reye’s syndrome.
Toxic encephalopathy with liver dysfunction, associated with aspirin use in viral infections
What is epilepsy?
Two or more unprovoked seizures due to abnormal brain electrical activity
What are tonic-clonic seizures?
Seizures with muscle stiffening (tonic) and jerking (clonic) phases, loss of consciousness
What are absence seizures?
Brief loss of consciousness, common in children aged 4-12, often mistaken for daydreaming
What are febrile seizures?
Seizures in children aged 6-60 months, triggered by fever, often benign
How is hydrocephalus caused?
Imbalance between CSF production and absorption, leading to increased ventricular pressure
What is the main treatment for hydrocephalus?
Ventriculoperitoneal (VP) shunt to drain excess CSF
What are the symptoms of shunt infection in hydrocephalus?
Fever, irritability, vomiting, headache, and seizures
What is a neuroblastoma?
Malignant extracranial tumor, often in the adrenal gland or sympathetic chain
What are common brain tumor symptoms in children?
Headache, vomiting, balance issues, and vision changes
What diagnostic tests are used for brain tumors?
MRI, CT scan, and lumbar puncture
What is submersion injury?
Injury from near-drowning, leading to hypoxia, asphyxiation, and aspiration
What is the primary concern in respiratory management of unconscious children?
Maintaining airway to prevent cerebral hypoxia
What medications are used for managing increased ICP?
Mannitol (osmotic diuretic), corticosteroids, and sedatives
What is the ketogenic diet used for?
Controlling seizures in children with epilepsy by promoting ketosis
What are the phases of post-traumatic brain injury syndromes?
Postconcussion syndrome, post-traumatic seizures, and hydrocephalus
How can positional plagiocephaly be prevented?
Tummy time, alternating head position during sleep, and supervised prone positioning
What are the main types of seizures based on onset?
Partial (localized), generalized (both hemispheres), and unclassified
What is myoclonic seizure?
Sudden, brief muscle contractions that can be single or repetitive, with or without consciousness loss
What are infantile spasms?
Seizures in infants aged 6-8 months with poor prognosis for normal intelligence
What causes nonbacterial (aseptic) meningitis?
Principally viruses, such as enteroviruses, with symptoms of headache, fever, and nuchal rigidity
What is the pathophysiology of submersion injuries?
Hypoxia, asphyxiation, aspiration, and hypothermia leading to cardiac arrest and CNS damage
What are the complications of subdural and epidural hematomas?
Increased ICP, brain herniation, and possible death if not treated promptly
What are the typical signs of encephalitis?
Sudden fever, headache, stiff neck, altered mental status, and possibly seizures
How is pain managed in comatose children?
Use opioids like morphine cautiously, monitor vitals, and maintain a calm environment
What is the nursing care focus for children with brain tumors?
Preoperative education, body image concerns, and postoperative recovery support
What is positional plagiocephaly?
Cranial asymmetry from prolonged supine positioning; managed by repositioning and tummy time
What is the typical treatment approach for bacterial meningitis?
Isolation, antibiotics, ICP control, and seizure management
What is the role of the Pediatric Glasgow Coma Scale (GCS)?
To assess eye, verbal, and motor responses; score ≤8 indicates coma
How do neuroblastomas typically present?
Silent tumors often metastasized at diagnosis, primarily in the adrenal gland or sympathetic chain
