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Peds > Neuro > Flashcards

Neuro Flashcards

1
Q

Pediatric Differences

A
  1. cranial bones not ossified
  2. fontanels and suture lines
  3. immature nerves
  4. lack of mylenation
  5. head larger than body
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2
Q

Cognitive Function

A

controls behavior, communication, memory, LOC

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3
Q

Cerebellar Function

A

controls balance, coordination, fine and gross motor

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4
Q

Moro

A

startle

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5
Q

palmer/planter grasp

A

put finger in hand/foot and they will grab

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6
Q

tonic neck

A

fencing

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7
Q

rooting

A

if you touch their cheek their head will move towards it

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8
Q

Babinski

A

<n2 years old toes will fan out (+)
> 2 years old you want (-) babinski
(COULD MEAN STROKE)

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9
Q

Skull Fractures

A

Linear: most common, overlying hematoma

Depressed: more dangerous, bone fragments in the brain, hospitalizations

Basilar: fx at the base of the skull, increased risk for meningitis, NO NG TUBE (will snake into the brain)

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10
Q

Microcephaly: patho

A

Patho: small brain
- genetic disorder, destructive insult, viral infections
- intellectual disability

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11
Q

Hydrocephalus

A

Patho: problem w/ production and reabsorption of CSF
- COGNITIVE IMPAIRMENT COMMON

S/SX: enlarged ventricles, bulging fontanels, increased head circumference, signs of increased ICP (HA, N/V, LOC)

Dx: prenatally

Tx: remove obstruction, ventriculoperitoneal shunt

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12
Q

Myelomeningocele

A

Patho: protrusion of the meningeal sac that contains CSF, spinal cord, nerves

S/Sx: paralysis, weakness, sensory loss, neurogenic bladder (lack of bladder control)

Dx: prenatally elevated MSAFP

TX: surgical repair, braces for mobility (infection risk)

Prevention: folic acid during pregnancy

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13
Q

Positional Plagiocephaly

A

Patho: asymmetric flattening of the occiput “ABC campaign”

Tx: tummy time, torticollis-physical therapy, helmet wear

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14
Q

Cerebral Palsy

A

Patho: permanent disorders of mvt. + posture
MOST COMMON PERMANENT PHYSICAL DISABILITY

S/Sx: Abnormal muscle tone and lack of coordination, spasticity, seizures, milestones lagging, intellectual, vision, hearing, speech impairments

Tx: early recognition, therapy to reach childs fullest potential, feeding issue (G TUBE) , family support, socialization adapted educational opprtunities, meds

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15
Q

Guillan- barre Syndrome (GBS)

A

Patho: systemic weakness (nerve damage) w/progressive ascending paralysis

S/Sx: absent or diminished deep tendon reflexes
- ataxia= loss of muscle control
- within 6 wks of a gastro or flu - like illness

Tx: IV IG ( IV immunoglobulin )

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16
Q

Reye Syndrome

A

Patho: encephalitis (inflammation of the brain ) from ASA use after varicella and influenza
++ HIGH MORTALITY++

S/Sx: vomiting, mental status changes, seizures, unresponsive cerebral edema, fatty liver

Tx: supportive

17
Q

Bacterial meningitis

A

Patho: inflammation of the meninges caused by bacteria or virus

S/Sx: brain swelling, increased ICP, fever shrill cry, lethargic, altered LOC, vomiting, HA w/ nuchal rigidity (chin to chest = neck pain), photophobia (light bothers the eyes), Kernig’s and Brudzinski signs

Dx: CBC, lumbar puncture, blood cultures, CT, MRI

Tx: anitbiotics (must cross BBB high dose IV), fever management, seizure precautions, isolation, treat contact prophylactically

18
Q

What is status epilepticus

A

seizures that last for a long time or back to back seizures
- use LORAZEPAM to help

19
Q

what is the post-ictal phase

A

phase after the seizure, last 30-60 mins, patient is really drowsy

20
Q

What are the different types of seizures

A
  1. Partial or Focal= stares off
  2. Generalized= tonic-clonic
  3. Febrile= can get until age 5
  4. Epilepsy = common, abnormal firing of the brain
  5. Psychogenic nonepileptic seizure (PNES)= stress induced seizure ( not a true seizure but its real)
21
Q

Seizure (patho, tx, and nursing)

A

Patho: abnormal electrical activity in the brain (involuntary mvt. , behavioral sensory alterations

Tx: cant cure only manage ( w/meds, surgery, or vagal nerve stimulation). Never stop meds abruptly, compliance is important, maintain therapeutic levels

Nursing:
1. seizure precautions (o2, padding, suction)
2. protect the airway, time the seizure, observe activity
3. never leave the pt, never put anything in mouth
4. recovery position after post ictal phase (lay on left side

22
Q

Increased intracranial pressure (ICP): patho and s/sx

A

Patho: increased pressure due to infection, trauma, tumors

Early s/sx: HA, N/V, vision changes, high pitched cry, sunsetting eyes (eyes looked pushed down), buldging and tense fontanels

Late s/sx: decreased LOC, seizures, cushing triad, fixed/ dilated pupils, posturing (herniation), decerebrate (straight, rigid ) , decorticate (abonormal flexion)

23
Q

Increased intracranial pressure (ICP): Dx and nursing

A

Dx: labs, EEG, CT, MRI
- Glascow coma scale: score <8= comatose (think about intubation)
- IF INCREASED ICP SUSPECTED, NO LUMBAR PUNCTURE

Nursing: treat the cause, maintain airway, maintain cerebral perfusion (dopamine), frequent neuro assessments, manage pain, position head midline, HOB 30 , seizure precautions (make sure they have gag reflex )

24
Q

Traumatic Brain Injury (TBI): causes and s/sx

A

Causes: MVA, Falls, gun-related leads to brain swelling, and increased ICP

Mild s/sx: LOC, N/V, HA
Moderate s/sx: LOC 5-2 mins, HA, N/V
Severe S/sx: LOC> 10 min. will have s/sx of ICP
cushing triad, herniation, posturing, seizures

25
Q

what is cushing’s triad

A
  1. bradycardia
  2. irregular respirations
  3. wide pulse pressure

S/sx of severe ICP

26
Q

Traumatic brain injury: nursing / interventions

A

Nursing:
- Coup= injury from direct insult
- Contrecoup= injury to the brain from mvt. (bruise on the brain)
- Can have post traumatic seizure, intracranial hemorrhage, cerebral contusion,
- Can be caused by shaken baby syndrome
- Can have subarachnoid hemorrhage and epidural bleeding = life threatening

Interventions:
- mont. neuro status, air way and pain
- HOB 30 degrees, midline (helps w/ swelling)
- Quiet environment, dim the lights, family support
- seizure precautions

Peds (20 decks)

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