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Pediatrics > Neuro and Musculoskeletal > Flashcards

Neuro and Musculoskeletal Flashcards

1
Q

GBS risk for newborn?

MMR vaccination during pregnancy?

A

can cause meningitis in newborn.

just know they aren’t supposed to do this

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2
Q

assessment parameters for peds in neuro

what are some diagnostic tests

A

LOC, pupils, VS, Frequency is more often in peds than adults: 15 to every 2 hrs

  • CT
  • EEG
  • Xray
  • Ultra sound
  • LP/Intracranial pressure
  • cbc, electrolytes, blood cultures, BMP
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3
Q

Epilepsy nurse responsibilities

A
  • prevent injury, keep on their side to prevent aspiration
  • administer
  • dont put anything in they mouth
  • never leave the child un attended
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4
Q

Infant reflexes ( add the rest)

A

Moro, gallant, tonic neck, rooting, sucking, palmar and plantar grasp goes away within 4 to 6 months
babinski goes away in 12 months

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5
Q

Increase intra cranial pressure manifestation for infants

A
  • high pitched cry
  • poor feeding
  • fontanels would be flat if dehydrated and bulging if ICP
  • irritability
  • sun setting eyes
  • scalp veins
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6
Q

ICP for children manifestation

A
  • complain of HD
  • Vomiting
  • seizures
  • diplopia or blurred vision
  • irritability and restlessness
  • drowsiness, indifference, decrease mobility
  • inability to follow commands
  • memory loss
  • weight loss
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7
Q

late signs of ICP

A 
decrease LOC, response to command, response to stimuli
alteration in pupil size and reactivity
papilledema
decerebrate and decorticate 
cheyne stokes respirations
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8
Q

which is worse and describe each : decorticate or decerebrate

A

decorticate is inward flexion

decerebrate is outward flexion is worse

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9
Q
  1. what is craniosynostosis?

2. how does it affect the child?

A
  1. premature closure of sutures in skull

2. impairs growth and development of brain, expect delayed developmental milestones

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10
Q

migraines

  1. what would the nurse assess for?
  2. manifestation
  3. treatments
A
  1. fatigue, dehydration, caffeine, caffeine withdrawal, stress, malnutritation
  2. HD, N/V, photophobia, fatigue
  3. Ibuprofen, caffeine, meds provided
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11
Q

Meningitis

  1. transmitted through?
  2. diagnosed through?
  3. nursing actions
  4. what are some causes
  5. how to prevent
A
  1. droplet
  2. LP, can sometimes be seen in blood culture
  3. assist in LP: side lying position with knees to chest.
  4. Herpes usually
  5. HiB vaccine
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12
Q

Meningitis manifestation

A
  • N/V, HD, fever, high pitched cry, poor feeding

- brusinski (flexion of extremities with flexion of neck) and kernig signs (resistance to extension of leg)

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13
Q

encephalitis

  1. what is this?
  2. manifestation
  3. spread through?
A
  1. inflammatory response of CNS that alters brain and spinal function
  2. Fever, HD, dizziness, ataxia, speech difficulties and paralysis, decrease activity.
  3. virus, insects
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14
Q

Reye syndrome

  1. what this be
  2. risk factors
  3. manifestation
  4. diagnosis
A
  1. viral infections, flu, chicken pox, use of asprin with viral ifnection
  3. fever, profound impaired consciousness, hepatic disorder, lethargy, severe vomiting, changes LOC, lethargy, hyperreflexia
  4. BMP, liver enzymes
  5. administer IV fluids, IandO, avoid anything that increases ICP, maintain semi fowler, Manitol
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15
Q

Aids encephalopathy

A

similar characteristics as other neuro precautions, its all about supportive treatment

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16
Q

describe:

  1. Atonic seizures
  2. myoclonic seizures
  3. status epilepticus
A
  1. muscle tone is lost
  2. muscle contractions
  3. seizures don’t end on their own, lasting longer than a few minutes, meds don’t work. This is an emergency
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17
Q

nurse responsibilities for shunt

A
  • assess for infection: fever, Vomiting, poor feeding,

- administer IV antibiotics if infection is present

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18
Q

treatment for SIADH

A

assess for and treat electrolyte imbalance

19
Q

nurse responsibilities for drowning precaution

A
  • all about educating prevention

- resuscitative measures

20
Q

how long postconcussion syndrom

A
  1. 8 weeks, limit school work
21
Q

nursing education for seizures

A
  1. CPR training
  2. rectal diazepam
  3. activity restriction
  4. safety devices - helmets, no swimming alone, awareness of school,
22
Q
  1. priorities for unconscious child

2. pain management for comatose child

A
  1. Airway, reduction of ICP, Shock treatment
  2. asses for signs of pain , agitation, rigidity. and alterations in vital signs (everything goes up except for oxygenation) . pain increases ICP
23
Q
  1. when would you see increase in creatinine kinase?

2. when would you sue muscle biopsy

A
  1. muscle damage, muscle dystrophy

2. muscle abnormalities

24
Q

clubfoot

  1. what is this?
  2. nursing care
A

1 deformity of ankle and foot
2. encourage parents proper care for infants and children to reach proper developmental milestones. walking may be difficult and delay in walking is common. cast is given. teach parents to care for cast : assess pulse, moisture, skin break down.

25
Q

leg-calve-perthes disease

  1. what is it
  2. occurs between?
  3. nursing responsibilities
A
  1. results in avascular necrosis of femoral head
  2. 2 to 12
  3. administer NSAID, eliminate weight bearing, PT may be needed
26
Q

Developmental hip dysplasia

  1. manifestation?
  2. nurse responsibilities
A
  1. asymmetry, unequal number of skin folds in posterior thigh, limited hip abduction, short femur, positive ortolani and barlow test. walking on toes on one foot and with a limp
  2. neurovascular test, assess skin, pain control, hydration and elimination
27
Q
  1. most common spinal deformity

2 nurse responsibilities

A
  1. scoliosis

2. no weight bearing after surgery, pain medication, body image issues

28
Q

Osteogenesis Imperfecta

  1. What is this
  2. manifestation
A
  1. excessive fragility and bone defects, hyperextensibility of ligaments
  2. loose sclera, early hearing loss, discoloured teeth
29
Q

cerebral palsy

  1. what is this
  2. manifestation
  3. nurse responsibilities
  4. risk factors
A
  1. impairment of motor function, muscle control, coordination, and posture
  2. failure to meet milestone, poor head control, abnormal posturing
  3. can affect multi system so assess and address all issues, help parents administer meds, seizure precaution
  4. head injury, decrease oxygenation to brain,
30
Q

myelomeningocele

  1. what is this
  2. manifestation
  3. treatment
  4. nurse teaching
A

1 . a type of spinobifida where the sace on the spine also has spinal nerves

  1. a sac protruding from where the spine is, the higher up in the spine the worse it is
  2. surgery in first few days of life, prone position
  3. latex allergy is common, intermittent catheterization every 3 to 4 hours, meds for pooping
31
Q
  1. muscular dystrophy signs and symptoms

2. nurse management

A
  1. gaward signs

2. administer corticosteroids, stretching exercises

32
Q

emergency managment

A
  1. ABC, prevent spinal cord injury, EMS/BLS, head to toe assessment
33
Q

effects of immobilty

A
  1. atrophy, decrease strength, bone demineralization (increase calcium intake), decrease metabolism, venous stasis, dependent edema, decrease oxygenation, constipation, skin break down, urinary retention, loss of sensory.
  2. depression and anxiety
34
Q

nursing interventions for immobility:

A
  1. reposition every 2 hours
  2. assess skin for redness and breakdown. Keep clean and dry
  3. ROM
  4. encourage intake of fluid
  5. encourage cough and deep breath
35
Q

manifestations of fractures

  1. diagnosed through?
  2. which heal faster younger or older?
A
  1. swelling, redness, diminished function and use, bruising
    Pain, Pulse, Pallor, Paresthesia (sensation distal to fracture), paralysis
  2. xray
  3. younger
36
Q
  1. nurse considerations for cast

2. nurse consideration for traction

A
  1. assess neuro vascular status, assess infection, apply ice, one finger should be able to fit
  2. keep body aligned, Halo traction, assess for skin break down
37
Q
  1. when would you be worried about compartment syndrome

2. what are things to be aware of in event of fracture

A
  1. uncontrolled pain within an hour of analgesia application (medical emergency)
  2. kidney stones, Emboli (wear stocking, assess extremities, allow ambulation if they can), osteomyelitis
38
Q

therapeutic management of sports injuries:

A

1.RICE: rest, ice, Compression, elevation

39
Q

torticollis

  1. what is this
  2. care
A
  1. limited neck motion, usually kept in one side

2. massage the neck

40
Q

Slipped femoral capital epiphysis, what do you do as the nurse

A
  1. educate to limit activity, know that obese children are more likely to get his
41
Q
  1. Kyphosis Vs lordosis

2. treatment

A
  1. kyphosis is curvature of upper spine, lordosis is curvature of lumbar
  2. bracing, family support
42
Q
  1. Juvenile arthritis treatment

2. symptoms

A
  1. NSAID treatment, PT, nutrition and exercise, splinting,

2. stiffness, swelling, Loss of monility, warm to touch areas, growth retardation

43
Q

spinal muscular atrophy affects what

2. what is nursing consideration

A
  1. affects the spinal nerves’ ability to communicate with muscles
  2. counseling, support, PT, OT, NG tube feeding, administer meds
44
Q

Guillain Barre syndrome focus of management

A

focus on rehabilitation, IV care, monitor VS

Pediatrics (15 decks)

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