Neuro 1 Flashcards
what are the peds neuro differences
- nervous system not mature at birth
- cranial bones not fused until 18 mos
- neuro changes may be less apparent
- primitive reflexes present at birth
this is a common causes of altered LOC in children
infectino of brain and meninges
describe the primitive reflexes
- disappear by 5 mos
- moro, palmar grasp. plantar grasp, rooting, sucking, tonic neck, stepping
- may reappear with neuro problems
what may be necessary when doing neuro diagnostic tests
sedation
when does the posterior fontanel close
2 months
when does the anterior fontanel close
18 mos
infants brains are…
- highly vascular
- important to keep oxygenated (needs 10x more)
- can be prone to fracture and hemorrhage
- support the neck
neuro changes in infants/babies
- tend to be more subtle
- irritability
- poor feeding
this is one of the most important indicators of neuro dysfunction
altered LOC
-confusion, delirium, lethargy, stupor, coma, persistent vegetative state
what is ICP
- condition that occurs when balance in volumes of brain tissues, CSF, and blood is disrupted
- increased ICP can lead to permanent damage
causes of increased ICP
tumors, bleeding, infeciton, edema, accumulation of CSF
signs of increased ICP
- headache
- diplopia
- V without N
- blurred vision
- mood swings
- manifestations vary with age
signs of increased ICP in infants
- inconsolable irritability
- poor feeding
- increased head circumference
- bulging fontanels
- high pitch cry
what are the sections of the Peds GCS
- eye opening
- verbal response
- motor response (*most critical aspect of test, should be automatic)
electrical disturbance withing the brain, resulting in changes of motor function, sensation or cog function
seizure
diagnosis of seizure
- neuro testing
- CT or MRI
- *EEG (standard test for diagnosing seizure disorder)
seizure treatment
- patent airway
- suction equipment and oxygen
- time seizure
- ensure safety and control
- if V, turn on side
- do not restrain
- prepare to administer meds
- stay with child
- document
seizure meds
- phenytoin (Dilantin)
- carbamazepine (Tegretol)
- Diazepam (Valium)
- Lorazepam (Ativan)
- Levetracetam (Keppra)
- (Topamax)
describe febrile seizures
- occur with fevere (39 C or 102 F) and associated with acute illness
- common neuro disorder
- occur between 6 mos-5yrs
- generalized and last less than 5 min
- uncertain cause
- may accompany URI or GI infection
intervention for febrile seizure
parental education and emotional support
describe bacterial meningitis
- acute inflammation of CNS
- Caused by a variety of bacterias
- can occur secondary to many infections (ie/ pneumonia, TB, OM)
the leading cause of neonatal meningitis is
- group B beta hemolytic strep
- E coli
what are the most common bacterias that cause bacterial meningitis
- penumococcal
- meningococcal
- haemophilus influenzae type B (mostly erradicated with Hib vaccine)
infant/young children manifestations of bacterial meningitis
- fever
- poor feeding
- bulging fontanels
- irritability (unconsolable)
- vomiting
- frequent seizures
