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NUR 331 > neuro > Flashcards

neuro Flashcards

1
Q

signs of increased ICP in children

A

Headache
Blurred vision
Diplopia
Sluggish pupils
Seizures

Nausea/vomiting
Increased sleepiness
Decreased school performance and motor function

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2
Q

Signs of increased intracranial pressure in infants

A

bulging fontanelle
High-pitched cry
Increased head circumference
Irritable when picked up
Sunsetting eyes

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3
Q

late signs of increased ICP

A

Decreased LOC
sensory response to pain
Fixed/dilated pupils
Deceborate/decorticate posturing

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4
Q

Cushing’s triad

A

Increased blood pressure
Decreased heart rate, RR
Widening pulse pressure

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5
Q

emergent nursing care of increased ICP

A

Stabilize spine
Frequent neuro checks and VS - Q1 hour
THERMAL REGULATION
Head midline
IVF
Low stimulation

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6
Q

what should be given for pain instead of morphine for children with increased ICP

A

Tylenol or ibuprofen

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7
Q

hydrocephalus

A

Increased CSF in ventricular system

Results in increased head circumference

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8
Q

VP/VA shunts

A

VP – drains into perineal cavity, preferred

VA – used if peritoneal not available, drains into thoracic cavity

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9
Q

Preop shunts

A

prevent breakdown of scalp
Keep eyes moist
Monitor for increased ICP

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10
Q

post op shunts

A

Bedrest on opposite side – flat
Keep drainage level with patients tragus
Monitor for abdominal distention
Measure abdominal girth
Avoid contact sports

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11
Q

what to do in case of infection with shunts

A

external temporary drainage system
Keep at level of ear
Close monitoring
Possible IV antibiotics

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12
Q

when to contact HCP post shunt

A

Sudden increase or decrease in drainage

Poor wave form

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13
Q

Basilar skull fracture

A

Raccoon/battle eyes
CSF leakage out of ears
High risk for meningitis

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14
Q

basilar skull fracture Nursing Care

A

Monitor temperature
No invasive procedures, or suctioning
Test CSF for glucose
Private room

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15
Q

what are the hallmark signs of a concussion?

A

Confusion
Amnesia

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16
Q

when to seek treatment for a concussion

A

Infant
Loss of LOC
Complains of head, neck pain
Vomiting repeatedly
Difficult to awake, console
Abnormal walking
Bleeding from nose or mouth
Watery discharge from nose, or ears
Positive glucose

17
Q

what type of medication can be used for brain injuries

A

Hypertonic solution – pools fluid away from brain

Steroids – decrease edema

18
Q

symptoms of progressively getting worse with brain injuries

A

Mounting agitation
Eyes not tracking
Asymmetric changes
Cushing triad

19
Q

Meningitis symptoms for a newborn

A

Poor feeding
Apnea, weak cry
Diarrhea
Jaundice
Tense fontanelle

20
Q

meningitis symptoms for infants

A

Fever
Poor feeding
N/V
Seizures
Irritable
High-pitched cry

21
Q

Meningitis for older kids

A

fever
Headache
Positive Kernigs/Brudzinski sign
Projectile vomiting
opisthotonos
Petechiae rash

22
Q

what is used to diagnose meningitis?

A

Lumbar puncture
Increased WBC, protein
Decreased glucose
Positive culture

23
Q

T/F lumbar puncture and cultures should be done after antibiotics given

A

False, before

24
Q

nursing care for meningitis

A

Droplet, isolation. 24 hours.
Seizure precautions
Neuro checks Q1 hour
Prevention – vaccines

25
Q

Encephalitis

A

Viral cause from HSV

26
Q

Reyes syndrome

A

encephalopathy with hepatic dysfunction

Can be caused from aspirin therapy in children

27
Q

what should be monitored especially with Reyes syndrome?

A

Abnormal coagulation
PT/PTT

Monitor for bleeding and liver function

28
Q

Febrile seizures

A

caused by fever greater than 101°F
Without known epilepsy

29
Q

when should treatment be initiated for seizures?

A

Greater than five minutes

30
Q

medication regimen for seizures

A

Start with one low-dose, make a way up if needed

Antiepileptic - Keppra

31
Q

diet for epileptic patients

A

If meds don’t work

Keto diet – high, fat, low carb, adequate protein
Supplemental vitamins

32
Q

last resort for treatment for epilepsy

A

Vagus nerve stimulation
Implanted Magnet

33
Q

nursing care for seizures

A

Observe time
Observe direction of eyes, LOC, movement
protect from injury, aspiration
Turn on side
No restraints or anything in the mouth
Blow by 02 less than 90%

34
Q

when should a rescue drug be given for seizures?

A

Greater than five minutes
Call HCP
Stay at bedside

35
Q

long-term education for seizures

A

Medic alert bracelet
Avoid triggers – stress, strobe, lights, sleep deprivation
Never alone in water
Wear a bike helmet
Avoid open flames and climbing Heights

NUR 331 (27 decks)

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