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PEDS > Neuro 1 > Flashcards

Neuro 1 Flashcards

1
Q

what are the peds neuro differences

A
  • nervous system not mature at birth
  • cranial bones not fused until 18 mos
  • neuro changes may be less apparent
  • primitive reflexes present at birth
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2
Q

this is a common causes of altered LOC in children

A

infectino of brain and meninges

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3
Q

describe the primitive reflexes

A
  • disappear by 5 mos
  • moro, palmar grasp. plantar grasp, rooting, sucking, tonic neck, stepping
  • may reappear with neuro problems
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4
Q

what may be necessary when doing neuro diagnostic tests

A

sedation

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5
Q

when does the posterior fontanel close

A

2 months

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6
Q

when does the anterior fontanel close

A

18 mos

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7
Q

infants brains are…

A
  • highly vascular
  • important to keep oxygenated (needs 10x more)
  • can be prone to fracture and hemorrhage
  • support the neck
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8
Q

neuro changes in infants/babies

A
  • tend to be more subtle
  • irritability
  • poor feeding
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9
Q

this is one of the most important indicators of neuro dysfunction

A

altered LOC

-confusion, delirium, lethargy, stupor, coma, persistent vegetative state

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10
Q

what is ICP

A
  • condition that occurs when balance in volumes of brain tissues, CSF, and blood is disrupted
  • increased ICP can lead to permanent damage
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11
Q

causes of increased ICP

A

tumors, bleeding, infeciton, edema, accumulation of CSF

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12
Q

signs of increased ICP

A
  • headache
  • diplopia
  • V without N
  • blurred vision
  • mood swings
  • manifestations vary with age
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13
Q

signs of increased ICP in infants

A
  • inconsolable irritability
  • poor feeding
  • increased head circumference
  • bulging fontanels
  • high pitch cry
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14
Q

what are the sections of the Peds GCS

A
  • eye opening
  • verbal response
  • motor response (*most critical aspect of test, should be automatic)
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15
Q

electrical disturbance withing the brain, resulting in changes of motor function, sensation or cog function

A

seizure

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16
Q

diagnosis of seizure

A
  • neuro testing
  • CT or MRI
  • *EEG (standard test for diagnosing seizure disorder)
17
Q

seizure treatment

A
  • 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
18
Q

seizure meds

A
  • phenytoin (Dilantin)
  • carbamazepine (Tegretol)
  • Diazepam (Valium)
  • Lorazepam (Ativan)
  • Levetracetam (Keppra)
  • (Topamax)
19
Q

describe febrile seizures

A
  • 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
20
Q

intervention for febrile seizure

A

parental education and emotional support

21
Q

describe bacterial meningitis

A
  • acute inflammation of CNS
  • Caused by a variety of bacterias
  • can occur secondary to many infections (ie/ pneumonia, TB, OM)
22
Q

the leading cause of neonatal meningitis is

A
  • group B beta hemolytic strep

- E coli

23
Q

what are the most common bacterias that cause bacterial meningitis

A
  • penumococcal
  • meningococcal
  • haemophilus influenzae type B (mostly erradicated with Hib vaccine)
24
Q

infant/young children manifestations of bacterial meningitis

A
  • fever
  • poor feeding
  • bulging fontanels
  • irritability (unconsolable)
  • vomiting
  • frequent seizures
25
Q

children/teens manifestations of bacterial meningitis

A
  • fever
  • headache
  • chills
  • vomiting
  • irritability
  • rigid neck
26
Q

classic findings of bacterial meningitis

A
  • Kernig’s sign

- brudzinski’s sign

27
Q

kernig’s sign

A

inability to extend the leg with the thigh is flexed anteriorly at hip

28
Q

brudzinski’s sign

A

neck flexion causes adduction and flexion movements of lower extremities

29
Q

diagnostic test of bacterial meningitis

A
  • CBC, blood culture, serum electrolytes and osmolality
  • lumbar puncture
  • culture and stain identify organism
  • WBCs increase
  • glucose level decrease
  • CT if increased ICP or abscess
30
Q

nursing activities of bacterial meningitis

A
  • monitor VS and neuro status
  • monitor hydration status (I&O)
  • monitor seizure activity
  • maintain isolation precautions
  • administer IV fluids and meds
  • comfort measures
31
Q

medical management of bacterial meningitis

A
  • resp isolation
  • IV antibiotics (7-21 days: ampicillin, ceftriaxone, cefotaxime, penicillin G, vancomycin)
  • adequate hydration

PEDS (24 decks)

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