Neuro 2 Flashcards
describe viral (aseptic) meningitis
- caused by a # of agents
- onset may be abrupt or gradual
- *symptoms usually resolve SPONTANEOUSLY and rapidly and client suffers from no residual effects
manifestations of viral (aseptic) meningitis
-fever, headache, malaise, GI symptoms, s/s of menigeal irritation
dx of viral (aseptic) meningitis
based on symptoms and lumbar puncture findings (gram stain and glucose normal and protein elevated)
describe reye syndrome
- acute encephalopathy, cerebral dysfunction caused by a toxic, injury, inflammatory, or anoxic insult that may result in permanent tissue damage
- elevated liver enzyemes and ammonia levels
what is reye syndrome associated with
ASPIRIN
parents should not use aspirin products in kids
what is reye syndrome characterized by
- cerebral edema
- hypoglycemia
- enlarged liver d/t elevated fatty acid
- hyperammonemia
- begins with N/V, mental status changes, seizure and progressive unresponsiveness
definitive diagnosis of reye syndrome
liver biopsy
medical management of reye syndrome
- **early diagnosis with aggressive therapy to treat s/s
- strict I and O
- monitor GCS for improvement
- parental support/education
_____ of children experience headaches by age 15 yrs
75%
very concerned about headache if…
- keeps child from going to school
- keeps child from doing extracurriculars
headache management
- assess for other neuro symptoms
- assist pt and family identify strategies for relieving headaches
- encourage headache log (trigger, relief, meds, how long it lasts, food??)
imbalance of CSF absorption of production resulting in head enlargement and increased ICP
hydrocephalus
causes of hydrocephalus and sign
malformation, tremors, hemorrhage, infection, trauma
*bulging fontanel
if left untreated what will hydrocephalus cause
permanent brain damage
types of hydrocephalus
- communicating
- noncommunicating
communicating hydrocephalus
results from impaired absorption within subarachnoid space
noncommunicating hydrocephalus
results from obstruction of CSF flow withing ventricular and is responsible for most cases in kids
dx of hydrocephalus
transillumiation of skull
x ray
MRI
CT
complications of hydrocephalus
increased ICP infection development delay shunt obstruction skin breakdown sensory deficit seizure
hydrocephalus treatment
- surgical insertion of mechanical shunt
- ventriculoperitoneal
- atrioventricular
ventriculoperitoneal
CSF drains into peritoneal cavity from lateral ventrical
atrioventricular
CSF drains into R atrium of the heart from lateral ventricle
complications of hydrocephalus shunt
- infection (fever, poor feeding, V, decreased LOC, seizure, inflammation at wound)
- malfunction (closely monitored)
signs of shunt malfunction
headache
drowsy, irritability
N/V
personality changes
hydrocephalus pt with many surgeries are at risk for
latex allergies
describe neural tube defects
- defects of osseous spine with neural herniation
* *associated with folic acid deficiency (recommends 0.4 mg/day folic acid to prevent it)
dx of neural tube defect
elevated levels of alpha fetoprotein by amniocentesis or prenatal US
mild types of neural tube defect
meningocele and spina bifida occulta
concerning type of neural tube defect
myelomeningocele
