Neuro 3

Question 1

describe spina bifida occulta

Answer 1

• mild
• posterior vertebral arches fail to fuse
• NO herniation of spinal cord or meninges
• NO loss of function
• may have dimple or hair duft

Question 2

describe meningocele

Answer 2

• mild
• no herniation of spinal cord or meninges
• no loss of function
• *sac is repaired in first 48 hrs of life

Question 3

describe myelomeningocele

Answer 3

• concerning
• posterior vertebral arches fail to fuse and SACLIKE herniation contains meninges, CSF, and portion of spinal cord or nerve roots
• surgery to repair within 24-48 hrs of birth
• neurologic bladder or bowel
• motor impairment of lower body
• risk for latex allergy d/t surgery

Question 4

spina bifida pre op care

Answer 4

• position on side/abdomen
• keep sac moist with sterile, saline soaked dressing
• avoid contamination of sac by urine/feces
• encourage parent bonding

Question 5

spina bifida post op care

Answer 5

• assess neuro status (no lower motor control)
• monitor I&Os
• monitor incision site
• discharge education

Question 6

describe cerebral palsy

Answer 6

• early onset of impaired movement and posture
• usually nonprogressive
• other problems:perceptual, language deficit, and intellectual impairment
• can be spastic type

Question 7

causes of cerebral palsy

Answer 7

• anoxia (birth asphyxia)
• prenatal brain abnormalities
• premature birth

Question 8

cerebral palsy is characterized by

Answer 8

• most common permanent physical disability of children

- characterized by abnormal muscle tone and coordination

Question 9

nursing care of cerebral palsy

Answer 9

• adequate nutrition
• maintain skin integrity
• promote physical mobility
• promote safety
• promote growth and development
• teach parental care

Question 10

describe spastic cerebral palsy

Answer 10

• most common form
• abnormal muscle tone
• hypertonic, poor postural control, balance and coordination
• gross and fine motor skills are impaired

Question 11

what is TBI

Answer 11

Defined as any trauma to the head that causes a change in level of consciousness or an anatomic abnormality of the brain – disrupts normal brain functioning

Question 12

describe TBI

Answer 12

• Leading cause of death and disability among children
• May be cause by blunt force (head struck by an object, shaking) or penetrating (bullet) mechanisms
• When an injury occurs the impact transfers energy through the skull and meninges to the brain

Question 13

who is at the greatest risk for TBI

Answer 13

• Infants are at greater risk for skull fractures and intracranial injury because they have thinner and more pliable skulls
• Children under age of 2 have a greater risk for intracranial injury after traumatic brain event

Question 14

Pathologic process involving the scalp, skull, meninges, or brain as a result of mechanical force

Answer 14

head injury

Question 15

leading cause of death and disability in children and adolescents

Answer 15

TBI

Question 16

manifestations of TBI

Answer 16

• Bruise or bump on the head / bruising over the temporal area or around the eyes
• Headache
• Bleeding from ears, nose, laceration
• Seizures
• Vomiting
• Irritability and agitation
• Loss of consciousness
• Decorticate or decerebrate posturing

Question 17

primary head injuries

Answer 17

Scalp lacerations
Concussion
Cerebral contusion
Skull fractures
Hematoma
Subarachnoid hemorrhage
Diffuse axonal injury

Question 18

secondary head injuries

Answer 18

Result from the severity of the primary brain injury:
Cerebral edema
Meningitis

Question 19

diagnostic test of head injuries

Answer 19

Skull X-ray
CT of the brain
MRI of the brain

Question 20

medical management of head injury

Answer 20

Goals are to prevent and minimize secondary injury to the brain
If severe injury, airway, breathing, and circulation

Question 21

sections of GCS

Answer 21

3 major areas; eye opening, motor response, and verbal response
-highest score 15 and lowest 3 / scores of 8 or less severe injury; 9 to 12 moderate injury; and 13 to 15 minor injury

Question 22

management of minor injuries

Answer 22

wake every 2 hours to check mental status / return to ED if vomiting, sleepiness, headaches, confusion, restlessness, personality changes, seizures, bleeding from ears or nose, inconsolable irritability occurs

Question 23

management of moderate injuries

Answer 23

usually admitted for observation

Question 24

management of severe injuries

Answer 24

admitted to PICU / may require surgical evacuation of subdural or epidural hematoma along with supportive management

Question 25

signs of increased ICP

Answer 25

increased respirations, decreased pulse, elevated blood pressure, seizure activity, vomiting, decreased in level of consciousness, change in pupil size and reactivity

Question 26

Required to provide his/her name to Abuse Hotline Counselor when reporting such as

Answer 26

Health care professionals
Day care providers
School Teachers
Law enforcement officers

Question 27

abuse hotline

Answer 27

1-800-96-ABUSE