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NCLEX: Pediatric > Nervous System > Flashcards

Nervous System Flashcards

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1
Q

Early signs of increased ICP in infants

A

Irritability, high-pitched cry, poor feeding, bulging fontanel, separated cranial sutures, setting sun sign (eyes appear driven downward)

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2
Q

Early signs of increased ICP in children

A

Headache, N/V, lethargy, seizures

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3
Q

Late signs of increased ICP

A

Bradycardia, decreased LOC, abnormal respirations (Cheyne Stokes), coma

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4
Q

Inflammation of the conjunctiva causing redness, swelling, and drainage from eye

A

Conjunctivitis (Pink eye)

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5
Q

Pink eye in infants is called

A

Opthalmia neonatorum

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6
Q

Opthalmia neonatorum is caused by exposure of what infections when going through the birth canal?

A

Chlamydia, gonorrhea

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7
Q

Opthalmia neonatorum prophylactic

A

Erythromycin ointment to eyes

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8
Q

S/S of conjunctivitis

A

Redness, itching, swollen eyelids, crusting of eyelids, purulent drainage

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9
Q

Treatment for bacterial conjunctivitis

A

Administration of ophthalmic antibiotic drops

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10
Q

Eye hygiene for child with conjunctivitis

A

Clean eye from inner canthus to outer eye, remove crust with warm, moist compresses

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11
Q

Eye disorder characterized by abnormal blood vessel growth in eyes of premature infants leading to scarring of retina and retinal detachment

A

Retinopathy of prematurity (ROP)

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12
Q

ROP risk factors

A

Prematurity, LBW, excessive supplemental oxygen

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13
Q

S/S of ROP

A

Abnormal blood vessels, white pupils, unusual eye movements, vision loss, detached retina

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14
Q

Prevention of ROP

A

Maintain oxygen therapy within the defined limits

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15
Q

Nearsightedness (can see things clearly up close, but have trouble seeing things that are far away)

A

Myopia

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16
Q

Farsightedness (ability to see things clearly that are far away, but difficult seeing things up close)

A

Hyperopia

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17
Q

The unequal curvature of the lens or cornea that causes blurred vision

A

Astigmatism

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18
Q

Decreased visual acuity in one eye

A

Amblyopia (lazy eye)

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19
Q

Misalignment of the eyes that causes inward or outward deviation

A

Strabismus

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20
Q

S/S that a child may have a visual impairment

A

Headache, dizziness, squinting, excess tearing, rubbing eyes, difficulty reading or poor school performance

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21
Q

Interpret 20/20 vision

A

Child can see something from 20 feet away that most people can see from 20 feet away

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22
Q

Strabismus treatment

A

Occlusion therapy: patch the strong eye to force muscles of affected eye to work harder to keep eye aligned

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23
Q

Most common hearing loss characterized by an issue with the transmission of sound getting into the cochlea (middle ear problem)

A

Conductive hearing loss

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24
Q

Conductive hearing loss is typically caused by

A

Recurrent otitis media

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25
Q

Hearing loss characterized by damage to the inner ear or auditory nerve caused by congenital defects, ototoxic medications, infections, or exposure to excessive noise

A

Sensorineural hearing loss

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26
Q

S/S of hearing loss in infants

A

Lack of startle reflex, lack of babbling, indifference to sound, failed newborn hearing assessment

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27
Q

S/S of hearing loss in children

A

Speech delay, speak in monotone voice or yell all the time, inattentiveness, shy/withdrawn

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28
Q

Conductive hearing loss treatment

A

Myringotomy (incision into tympanic membrane, placement of tubes allowing drainage of fluid out of middle ear — for recurrent otitis media), hearing aid

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29
Q

Sensorineural hearing loss treatment

A

Cochlear implant

30
Q

Hearing loss nursing care

A

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

31
Q

Most common form of seizures in children

A

Febrile

32
Q

Seizure caused by a sudden spike in body temperature (over 38 C) without an underlying seizure-provoking disorder or cause

A

Febrile seizure

33
Q

Febrile seizures risk factors

A

Children between ages 6 months and 5 years

34
Q

S/S of febrile seizures

A

Loss of consciousness, uncontrollable shaking of arms and legs

35
Q

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

A

Concussion

36
Q

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

A

Hydrocephalus

37
Q

Life-threatening disorder that causes swelling in the brain and liver

A

Reye’s Syndrome

38
Q

S/S of Reye’s syndrome

A

Vomiting, confusion, seizures, coma, death

39
Q

Key risk factors for Reye’s syndrome

A

Recent viral illness (influenza), use of aspirin

40
Q

Labs associated with Reye’s syndrome

A

Elevated ALT, AST, bilirubin and ammonia

41
Q

Reye’s syndrome nursing care

A

Monitor patient for increased ICP, implement seizure precautions, implement bleeding precautions

42
Q

Key risk factors for lead poisoning

A

Pre-1978 housing, home renovation

43
Q

Chelation therapy is required for blood lead levels greater than

A

45 mcg

44
Q

Treatment for lead poisoning characterized by administration of drug that binds to heavy metals in the body and helps to remove them from body

A

Chelation therapy

45
Q

Family teaching for prevention of lead exposure/poisoning

A

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

46
Q

Neural tube defect that causes baby’s spinal cord not to develop properly in utero

A

Spina bifida

47
Q

Spina bifida risk factors

A

Insufficient folic acid intake during pregnancy**, maternal diabetes, maternal drug use

48
Q

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

A

Spina bifida occulta

49
Q

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

A

Meningocele

50
Q

Type of Spina bifida characterized by protrusion of sac or cyst over spinal cord containing CSF, meninges, and part of the spinal cord

A

Myelomeningocele

51
Q

Nursing interventions for meningocele or myelomeningocele

A

Cover sac with sterile saline-moistened non-adherent dressing, place baby in prone position with hips flexed

52
Q

Complications of Spina bifida

A

Hydrocephalus, latex allergy, increased risk for pressure injuries and burns (d/t lack of sensation), bladder dysfunction (often requires intermittent catheterization)

53
Q

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

A

Cerebral palsy

54
Q

S/S of cerebral palsy

A

Ataxia (lack of coordination), muscle spasticity, impaired gait
Severe: intellectual disability, seizures, impaired swallowing, speech, vision, and hearing

55
Q

Treatment of muscle spasticity related to cerebral palsy

A

Botox, intrathecal baclofen

56
Q

Physical features associated with Down syndrome (trisomy 21)

A

Broad flat nose, low-set ears, protruding tongue, single uninterrupted palmar crease

57
Q

X-linked dominant chromosomal abnormality that causes intellectual disability and autism

A

Fragile X

58
Q

Which gender gets more severe symptoms of fragile X?

A

Males

59
Q

Physical features of fragile X

A

Long face, prominent forehead, protruding ears
Other S/S: cognitive impairment, speech abnormalities, poor eye contact, hyperactivity

60
Q

X-linked recessive neuromuscular disease that causes muscle degeneration and weakness, skeletal muscle atrophy, and cardiac muscle atrophy

A

Duchenne’s muscular dystrophy

61
Q

Duchenne’s muscular dystrophy risk factors

A

Family hx, males

62
Q

S/S of Duchenne’s muscular dystrophy

A

Delayed motor movement, cognitive impairment, muscle weakness, waddling gait, elevated CK

63
Q

Duchenne’s muscular dystrophy nursing care

A

Initiate palliative care (death usually occurs in 20s d/t respiratory muscle weakness and/or cardiomyopathy)

64
Q

Treatment of ADHD

A

CNS stimulants (amphetamine mixtures, methylphenidate)

65
Q

Key side effects of CNS stimulants for ADHD

A

Insomnia, decreased appetite — advise parents to provide meds in morning and administer with meals or after meals

66
Q

ADHD nursing care

A

Monitor growth and weight throughout therapy

67
Q

ADHD family education

A

Maintain structure environment with consistent rules, decrease distractions

68
Q

Neurological disorder that causes behavioral and psychological problems

A

Autism (ASD)

69
Q

ASD risk factors

A

Family hx, males

70
Q

S/S of ASD

A

Impaired social interactions, repetitive behavior, lack of eye contact, speech delays, cognitive impairment, trouble adapting to routine changes

71
Q

ASD family education

A

Provide structured environment, decrease stimuli, give plenty of notice prior to change in routine

NCLEX: Pediatric (4 decks)

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