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exam 3 > Neuro > Flashcards

Neuro Flashcards

1
Q

Excess production, impaired absorption or block in the flow of the CSF that results in an excess amount of CSF w/in the cerebral ventricles

A

Hydrocephalus

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2
Q

Increased intracranial pressure vs shock

A

SHOCK: ^P, decr. BP
IIP: ^BP, decr. P

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3
Q

Hydrocephalus tx

A

VP shunts
VA shunts (to L atrium)
EVD

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4
Q

VP Shunts

A

Placed asap to prevent further damage
Revised due to growth
Can get infected and need to be externalized= EVD

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5
Q

NTD w/protrusion of meninges, CSF and spinal cord

A

Myelomeningocele

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6
Q

Cause of Myelomeningocele

A

Low folic acid intake= vitamin B12 deficiency

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7
Q

Myelomeningocele sx

A 
Lower extremities may be partially or totally paralyzed
Bowel/bladder problems
Orthopedic problems
If high, may have resp. distress
Loss of sensation below level of lesion
Hydrocephalus
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8
Q

Myelomeningocele diagnosis

A

Prenatal U.S.

Amniocentesis shows ^ AFP

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9
Q

Myelomeningocele tx

A

Surgery

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10
Q

Myelomeningocele positioning pre op

A

Prone, to keep stool/urine away from lesion

4 point restrain= Bradford Frame

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11
Q

Myelomeningocele mgmt

A 
Family support
Prevent infection
Assess for hydrocephalus**
Teach how to straight cath/May Crede
Bowel program/high fiber/suppositories
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12
Q

Feeding in the prone position

A

Difficult

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13
Q

Inflammation of meninges

A

Meningitis

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14
Q

Is Meningitis bacterial or viral?

A

Can be both

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15
Q

Cause of Meningitis

A

Infection (otitis, sinusitis, cellulitis, pneumonia)
Penetrating trauma
Nero intervention

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16
Q

How does Meningitis occur?

A

Bacteria enter bl. supply-> disseminated thru body->into CSF and spread thru subarachnoid space-> inflammatory response->WBC cover brain->brain is edematous-> II

17
Q

Meningitis sx

A 
Fever
Feeding alterations
Bulging anterior fontanels
Seizures
N/V
Photophobia
Opisthotonic pos.
Nuchal rigidity
HA
18
Q

If a rash is present w/Meningitis, what could this be?

A

Meningococcemia

19
Q

Positive Kernigs sign

A

Have child lie supine w/ hips flexed. If Kernigs sign is present, child will resist having legs extended

20
Q

Brudzinski’s sign

A

The child should be supine. If there is meningeal irritation, when the child’s head is flexed forward, the child will flex hips and knees

21
Q

Meningitis diagnosis

A 
Hx
Contact w/ sick ind.
Rash
Sz.
Fever
Behavior changes
Labs
Lumbar puncture
22
Q

Meningitis labs

A

CBC
Culture of CSF
Serum el./ Osmo (hydration and clotting)

23
Q

CSF levels

A

50 mm for non crying baby
85 mm for child
> 180 mm = meningitis
> 100 WBC = meningitis

24
Q

CSF sx

A

Cloudy

Glucose is decr. / protein ^

25
Q

CSF diagnosis

A

Urine culture

26
Q

Meningitis tx

A 
Cardioresp. monitor
O2
Shock= fl. and drug support
Antibiotics
Steroids
27
Q

Meningitis mgmt

A 
Isolation; for 24 hr p antibiotics have been started
Asses neuro status freq.
Adm. antibiotics
Keep child comfortable/ env. dark
Maintain temp.
28
Q

Life threatening encephalopathy w/accompanying microvascular fatty deposits in the liver and kidney

A

Reyes

29
Q

Causes of Reyes

A

ASA
Influenza
Chicken pox

30
Q

What does Reyes lead to?

A 
Enlarged liver
Depleted glucose stores
Enzyme reduction (convert ammonia to urea)
Changes in liver enzymes
Cerebral edema w/IIP
31
Q

Reyes liver enzymes

A 
SGOT (AST)
SGPT (ALT)
LDH
Serum ammonia
Decr. PT
32
Q

Reyes sx

A 
Of a mild infection
Vomiting
Behavior changes
Decr. LOC
Comatose-> death w/in 2-3 days of sx
33
Q

Reyes diagnosis

A 
CBC
Chemistries
CSF
Clotting times
Bun
Bl. gases
Amylase
Liver fctn studies
Liver biopsy
Urinalysis
34
Q

Reyes tx

A

ICU
Paralyzed= vent.
Sz. tx
Indwelling cath.

35
Q

Reyes mgmt

A

Monitor vitals, neuro

Family support

exam 3 (6 decks)

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