Nervous System Flashcards
Early signs of increased ICP in infants
Irritability, high-pitched cry, poor feeding, bulging fontanel, separated cranial sutures, setting sun sign (eyes appear driven downward)
Early signs of increased ICP in children
Headache, N/V, lethargy, seizures
Late signs of increased ICP
Bradycardia, decreased LOC, abnormal respirations (Cheyne Stokes), coma
Inflammation of the conjunctiva causing redness, swelling, and drainage from eye
Conjunctivitis (Pink eye)
Pink eye in infants is called
Opthalmia neonatorum
Opthalmia neonatorum is caused by exposure of what infections when going through the birth canal?
Chlamydia, gonorrhea
Opthalmia neonatorum prophylactic
Erythromycin ointment to eyes
S/S of conjunctivitis
Redness, itching, swollen eyelids, crusting of eyelids, purulent drainage
Treatment for bacterial conjunctivitis
Administration of ophthalmic antibiotic drops
Eye hygiene for child with conjunctivitis
Clean eye from inner canthus to outer eye, remove crust with warm, moist compresses
Eye disorder characterized by abnormal blood vessel growth in eyes of premature infants leading to scarring of retina and retinal detachment
Retinopathy of prematurity (ROP)
ROP risk factors
Prematurity, LBW, excessive supplemental oxygen
S/S of ROP
Abnormal blood vessels, white pupils, unusual eye movements, vision loss, detached retina
Prevention of ROP
Maintain oxygen therapy within the defined limits
Nearsightedness (can see things clearly up close, but have trouble seeing things that are far away)
Myopia
Farsightedness (ability to see things clearly that are far away, but difficult seeing things up close)
Hyperopia
The unequal curvature of the lens or cornea that causes blurred vision
Astigmatism
Decreased visual acuity in one eye
Amblyopia (lazy eye)
Misalignment of the eyes that causes inward or outward deviation
Strabismus
S/S that a child may have a visual impairment
Headache, dizziness, squinting, excess tearing, rubbing eyes, difficulty reading or poor school performance
Interpret 20/20 vision
Child can see something from 20 feet away that most people can see from 20 feet away
Strabismus treatment
Occlusion therapy: patch the strong eye to force muscles of affected eye to work harder to keep eye aligned
Most common hearing loss characterized by an issue with the transmission of sound getting into the cochlea (middle ear problem)
Conductive hearing loss
Conductive hearing loss is typically caused by
Recurrent otitis media
Hearing loss characterized by damage to the inner ear or auditory nerve caused by congenital defects, ototoxic medications, infections, or exposure to excessive noise
Sensorineural hearing loss
S/S of hearing loss in infants
Lack of startle reflex, lack of babbling, indifference to sound, failed newborn hearing assessment
S/S of hearing loss in children
Speech delay, speak in monotone voice or yell all the time, inattentiveness, shy/withdrawn
Conductive hearing loss treatment
Myringotomy (incision into tympanic membrane, placement of tubes allowing drainage of fluid out of middle ear — for recurrent otitis media), hearing aid
Sensorineural hearing loss treatment
Cochlear implant
Hearing loss nursing care
Provide referral to speech therapist and audiologist, encourage family to get yearly hearing screens, prevent exposure to hazardous noises and provide ear protection as needed
Most common form of seizures in children
Febrile
Seizure caused by a sudden spike in body temperature (over 38 C) without an underlying seizure-provoking disorder or cause
Febrile seizure
Febrile seizures risk factors
Children between ages 6 months and 5 years
S/S of febrile seizures
Loss of consciousness, uncontrollable shaking of arms and legs
Temporary alteration in brain function that is typically self-resolving in about one to three weeks and treatment is focused on rest and gradual return to activities
Concussion
An increase in cerebral spinal fluid that causes a build-up of fluid in the brain which can result in permanent brain damage if left untreated
Hydrocephalus
Life-threatening disorder that causes swelling in the brain and liver
Reye’s Syndrome
S/S of Reye’s syndrome
Vomiting, confusion, seizures, coma, death
Key risk factors for Reye’s syndrome
Recent viral illness (influenza), use of aspirin
Labs associated with Reye’s syndrome
Elevated ALT, AST, bilirubin and ammonia
Reye’s syndrome nursing care
Monitor patient for increased ICP, implement seizure precautions, implement bleeding precautions
Key risk factors for lead poisoning
Pre-1978 housing, home renovation
Chelation therapy is required for blood lead levels greater than
45 mcg
Treatment for lead poisoning characterized by administration of drug that binds to heavy metals in the body and helps to remove them from body
Chelation therapy
Family teaching for prevention of lead exposure/poisoning
Increased intake with calcium and iron to decrease lead absorption, wet mop floors, check home for peeling or flaking paint, frequently wash toys and pacifiers
Neural tube defect that causes baby’s spinal cord not to develop properly in utero
Spina bifida
Spina bifida risk factors
Insufficient folic acid intake during pregnancy**, maternal diabetes, maternal drug use
Type of Spina bifida in which malformation of the spinal cord is not visible, but there may be an abnormal tuft of hair, dimple, or birthmark over the affected area
Spina bifida occulta
Type of Spina bifida characterized by a protrusion of a sac or cyst over the baby’s spinal cord that contains cerebral spinal fluid and meninges
Meningocele
Type of Spina bifida characterized by protrusion of sac or cyst over spinal cord containing CSF, meninges, and part of the spinal cord
Myelomeningocele
Nursing interventions for meningocele or myelomeningocele
Cover sac with sterile saline-moistened non-adherent dressing, place baby in prone position with hips flexed
Complications of Spina bifida
Hydrocephalus, latex allergy, increased risk for pressure injuries and burns (d/t lack of sensation), bladder dysfunction (often requires intermittent catheterization)
Neurological disorder characterized by abnormal intrauterine development of the brain or some kind of hypo or brain injury that damages the cerebral cortex resulting in that impaired body movement and muscle coordination
Cerebral palsy
S/S of cerebral palsy
Ataxia (lack of coordination), muscle spasticity, impaired gait
Severe: intellectual disability, seizures, impaired swallowing, speech, vision, and hearing
Treatment of muscle spasticity related to cerebral palsy
Botox, intrathecal baclofen
Physical features associated with Down syndrome (trisomy 21)
Broad flat nose, low-set ears, protruding tongue, single uninterrupted palmar crease
X-linked dominant chromosomal abnormality that causes intellectual disability and autism
Fragile X
Which gender gets more severe symptoms of fragile X?
Males
Physical features of fragile X
Long face, prominent forehead, protruding ears
Other S/S: cognitive impairment, speech abnormalities, poor eye contact, hyperactivity
X-linked recessive neuromuscular disease that causes muscle degeneration and weakness, skeletal muscle atrophy, and cardiac muscle atrophy
Duchenne’s muscular dystrophy
Duchenne’s muscular dystrophy risk factors
Family hx, males
S/S of Duchenne’s muscular dystrophy
Delayed motor movement, cognitive impairment, muscle weakness, waddling gait, elevated CK
Duchenne’s muscular dystrophy nursing care
Initiate palliative care (death usually occurs in 20s d/t respiratory muscle weakness and/or cardiomyopathy)
Treatment of ADHD
CNS stimulants (amphetamine mixtures, methylphenidate)
Key side effects of CNS stimulants for ADHD
Insomnia, decreased appetite — advise parents to provide meds in morning and administer with meals or after meals
ADHD nursing care
Monitor growth and weight throughout therapy
ADHD family education
Maintain structure environment with consistent rules, decrease distractions
Neurological disorder that causes behavioral and psychological problems
Autism (ASD)
ASD risk factors
Family hx, males
S/S of ASD
Impaired social interactions, repetitive behavior, lack of eye contact, speech delays, cognitive impairment, trouble adapting to routine changes
ASD family education
Provide structured environment, decrease stimuli, give plenty of notice prior to change in routine
