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Nur 4410 Peds Exam #2 > Neuro and Sensory Contd > Flashcards

Neuro and Sensory Contd Flashcards

1
Q

What nervous system involves the brain & spinal cord?

A

CNS

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2
Q

What nervous system involves the nerves?

A

PNS

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3
Q

PNS divided into what two nervous systems?

A

sensory-somatic nervous system and autonomic nervous system

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4
Q

removes waste and supplies nutrients to brain and spinal cord

A

CSF

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5
Q

a term that refers to the skull’s ability to indent under pressure

A

craniotabes

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6
Q

Skull ossification continues through what?

A

puberty until mid-20s

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7
Q

Pressure of CSF in the subarachnoid space between the skull and the brain

A

ICP

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8
Q

Complications of increased intracranial pressure?

A

decreasing cerebral perfusion leads to ischemia and anoxia

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9
Q

Early signs of Increased Intracranial Pressure in infants:

A

headache, emesis, change in LOC, decrease in GCS score, irritability, sunsetting eyes, decreased eye contact, pupil dysfunction, seizures

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10
Q

Late signs of Increased Intracranial Pressure in infants:

A

further decrease in LOC, bulging fontanels, decreasing spontaneous movements, posturing, PAPILLEDEMA, pupil dilation with decreased or no response to light, increased blood pressure, irregular respirations, cushings triad

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11
Q

Priority care of Increased ICP?

A

maintaining airway & cerebral perfusion, PREVENT SEIZURES

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12
Q

CPP formula

A

MAP-ICP

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13
Q

When do you intubate a patient (based on GCS)?

A

GCS

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14
Q

Vent Settings for increased ICP

A

PO2 120-140 mm hg, PCO2 30-35 mm Hg

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15
Q

temp elevation (non –responsive to antipyretics), hypothermic blanket to keep T< F, b/c shivering can increase ICP) is a sign of what in increased ICP

A

intracranial bleeding

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16
Q

What kind of fluids are given to patients with increased ICP?

A

ISOTONIC

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17
Q

Medications for increased ICP

A

Mannitol, barbiturates, sedation

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18
Q

What is a way of temporary compensation for increased ICP?

A

open fontanels

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19
Q

Structural defects in the Cerebellum, caused by an indented bony space at the lower rear of the skull. Women are affected more than men. Type II and III are most often seen in children

A

Arnold-Chiari Malformation

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20
Q

Symptoms including dizziness, muscle weakness, numbness, vision problems, headache, and problems with balance and coordination What is it??

A

Arnold Chiari Malformation

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21
Q

Treatment of Arnold Chiari Malformation

A

surgery

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22
Q

Postop care for Arnold-Chiari Malformation?

A

q 1 hr neuro checks, incision care(observation for CSF leak), pain management

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23
Q

Premature closure of one or more cranial sutures due to a defect in ossification Growth stops in direction that is perpendicular to the closed suture but continues in the direction parallel to the closed suture

A

Craniosynostosis

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24
Q

most common neuro tumor in kids; slow growing; surgery

A

Astrocytoma (glioma)

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25
Q

most common malignant brain tumor; surgery, chemotherapy, radiation

A

Medulloblastoma

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26
Q

brain tumor inside of brainstem; surgery not an option; radiation possible; lifespan less than 2 years after diagnosis

A

Brain Stem glioma:

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27
Q

brain tumor that usually in posterior fossa; hydrocephalus; surgery

A

Ependymomas

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28
Q

Electrical disturbance in brain Causes: genetic, trauma/injury, infection, anoxia, toxic ingestion, hypoglycemia, maternal teratogens, congenital causes, idiopathic

A

Seizures

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29
Q

< 3 y.o., etiology unknown, tonic-clonic seizure, fever, no epileptiform, < 15 min, loss of consciousness, no aura, post-confusion, severity of temp. elevation

A

Febrile seizures

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30
Q

localized to one area of the brain, S&S: one area affected: hands, lips, wrist, arms, face. Impaired loss of consciousness at onset.

A

Partial Seizures

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31
Q

A seizure is occuring, what a nurse should do?

A

Call for help and stay with a child Airway, respirations are priority Loosen clothing , lateral Medication: (Valium, Ativan, Cerebryx) per order After seizure care: lateral recumbent position Continuous CR/Sat monitor Do not restrain Collaborate between PCP, school nurse, family

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32
Q

Life- threatening disease that leads to multisystem failure – primarily cerebral edema Cause: unknown; although linked to aspirin products used to treat viral infections Recommended not to give children under the age of 19 ASA for any fever-causing illnesses.

A

Reye Syndrome

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33
Q

Diagnostic Procedure for Reye Syndrome:

A

Liver biopsy, Lumbar Puncture (to rule out meningitis), Labs (increased ammonia, liver enzymes or prolonged coagulation may indicate)

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34
Q

Nursing Interventions for Reye Syndrome:

A

Maintain hydration Administer prescribed osmotic diuretics Monitor coagulation

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35
Q

Inflammation of the meninges, Viral vs. bacterial

A

Meningitis

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36
Q

S&S of Meningitis in Neonates

A

Hard to diagnose Vomiting, poor muscle tone, irritability, lethargy, irregular respirations/apnea

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37
Q

S&S of Meningitis in 2mos-2yo children

A

High-pitched cry, seizures, fever, poor feedings, vomiting, irritable, bulging fontanels, possible nuchal rigidity

38
Q

S&S of Meningitis in 2yo-adolescence

A

Excruciating Headache Irritable, Nausea, vomiting, fever, chills, photophobia, nuchal rigidity, positive Brudzinski’s sign, positive Kernig’s signs, seizures

39
Q

Meningitis caused by S.pneumonia (bacterial organism) will have what distinct symptom?

A

draining ear

40
Q

Meningitis caused by N.meningitides (bacterial organism) will have what distinct symptom?

A

red macular rash

41
Q

Meningitis caused by N.meningitides and H.influenza (bacterial organism) will have what distinct symptom?

A

involvement of the joints

42
Q

Classic finding on examination for a child suspected of meningitis include a positive sign from what two signs?

A

Kernig’s or Brudzinski’s Sign

43
Q

Diagnosis of Meningitis

A

CSF, Assume positive in infants

44
Q

Nursing Inverventions for Meningitis:

A

Monitor ICP; neuro checks q2; isolate children, hydrate, decrease stimuli, prevent future episodes, comfort care

45
Q

How to prevent future episodes of Meningitis:

A

Teach family about complete and early treatment of URI; Hib vaccine in children under 5

46
Q

Usually viral in origin Signs and symptoms - variable Confusion High fever Hallucinations Seizures Nuchal rigidity Coma What is it??

A

Encephalitis

47
Q

Nursing Care for Encephalitis:

A

Antivirals/Antibiotic Neuro checks q2h HOB elevated Antipyretics

48
Q

Infectious material in the brain tissue

A

Brain Abscess

49
Q

Signs and symptoms Localized headache Fever Drowsiness Ataxia Seizures What is it??

A

Brain Abscess

50
Q

Nursing care for brain abscess

A

Watch for symptoms of increased intracranial pressure Antimicrobial therapy Post surgical care

51
Q

Ascending muscle weakness or paralysis Rare, autoimmune Signs and symptoms Ascending muscle weakness/paralysis Three phases: acute, second, recovery

A

Guillain-Barre Syndrome

52
Q

Medications given to a patient with Guillain-Barre Syndrome

A

Administer immunoglobulin (IVIG) Steroids O2 Sats Range of motion Pain control

53
Q

Neural tube fails to close

A

Spina Bifida - Neural tube defects (NTDs)

54
Q

no spinal cord involvement, Dimple/tuft of hair

A

Occulta, S&S of Spina Bifida

55
Q

meninges protrude but no neural elements present

A

Meningoecele, S&S of Spina Bifida

56
Q

most sever S&S of spina bifida

A

Myelomeningocele

57
Q

3 major S&S of Spina Bifida

A

Occulta, Meningocele, Myelomeningocele

58
Q

Nursing Care for Spina Bifida:

A

prone position after birth, do not place bladder over defect, Latex allergy alert!

59
Q

Priority nursing intervention for Spina Bifida:

A

infection prevention

60
Q

Increase in CSF production, impedance of absorption, or an obstruction to flow

A

Hydrocephalus

61
Q

unable to reabsorb CSF

A

Communicating Hydrocephalus

62
Q

ventricular system does not communicate with arachnoid villi due to obstruction to CSF flow

A

Noncommunicating Hydrocephalus

63
Q

most common cause of Hydrocephalus; MRI shows narrowing of Aqueduct of Sylvius Enlargement of lateral and 3rd ventricles, but normal 4th ventricle

A

Aqueductal Stenosis

64
Q

S&S of Hydrocephalus in preemies

A

bradycardia, apnea, seizures, hypotonia, opthalmoplegia, sunset eyes, macrocephaly

65
Q

S&S of Hydrocephalus in Infants with open sutures

A

bulging fontanels, splayed sutures, sunset eyes, increased head circumference

66
Q

S&S of Hydrocephalus in Children

A

vomiting, lethargy, paralysis of upward gaze (Parinaud’s sign), frontal bossing, delayed development, headache

67
Q

Classic sign of Hydrocephalus

A

“Cracked pot” sound on percussion

68
Q

Nursing/medical treatment of Hydrocephalus:

A

LP Ventricular reservoir Shunts 3rd ventriculostomy (aqueductal stenosis) Measure head circumference

69
Q

Complication of Hydrocephalus medical treatment:

A

Shunt malfunction

70
Q

Most common permanent physical disability in childhood Nonprogressive, occurs before cerebral development is complete

A

Cerebral Palsy

71
Q

most common, stiff muscles because of increased muscle tone, and the muscles are predisposed to contracture. Will have poor posture, coordinated movement, and balance. Classified according to limbs affected.

A

Spastic Cerebral Palsy

72
Q

characterized by uncontrolled involuntary writhing movement of extremities

A

Athetoid (dyskinetic) Cerebral Palsy

73
Q

have difficulties with balance and depth perception. Walk with unsteady gait, demonstrate poor coordination, and often have fine motor control problems.

A

Ataxic Cerebral Palsy

74
Q

a child has two or more types of CP. Common symptoms: difficulty or inability to walk, speech difficulty, swallowing problems, breathing difficulties, bowel or bladder incontinence, seizures, vision problems, learning disabilities, hearing deficits, attention or behavioral problems, and impaired senses.

A

Mixed Cerebral Palsy

75
Q

Confusion to brief loss of consciousness after a mechanical blow to the head; transient and reversible

A

Concussion

76
Q

Skin and skull integrity maintained after blow to the head; damage to underlying tissue

A

Closed Injury

77
Q

bruise to brain

A

Contusion

78
Q

Blood clot within the skull; can cause increased ICP; result of skull fracture, venous or arterial tear; subdural hematoma is bleeding between the dura and the brain

A

Intracranial hematoma

79
Q

Complication of head injury Signs: fixed dilated pupils, deteriorating level of consciousness, Cheyne-Stokes respirations, hemodynamic instability, and abnormal posturing

A

Brain Herniation

80
Q

Nursing interventions for brain herniation

A

Elevate bed 30 degrees Administer Mannitol as prescribed Ventilate patient Frequent VS/ neuro checks

81
Q

is death from asphyxia due to suffocation caused by water entering the lungs and preventing the absorption of oxygen leading to cerebral hypoxia.

A

drowning

82
Q

is the survival of a drowning event involving unconsciousness or water inhalation and can lead to serious secondary complications, including death, after the event.

A

near drowning

83
Q

occurs when a person’s lungs become unable to extract oxygen from the air; laryngospasm w/out aspiration

A

dry drowning

84
Q

Extra-axial hemorrhages in subdural and subarachnoid spaces Retinal hemorrhages Skull films show fractures

A

Shaken Impact Syndrome

85
Q

Signs and symptoms Seizure activity, apnea, budging fontanels, coma, hemorrhage, bradycardia & cardiovascular collapse, poor feeding, lethargy, small for height/weight charts Sign of child abuse; mandated to report What is it??

A

Shaken Baby Syndrome

86
Q

Signs and symptoms Numbness, tingling, or loss of function What is it??

A

Spinal Cord Injury

87
Q

Speak in a normal tone of voice, state of consciousness

A

Alertness

88
Q

Speak in a loud voice, state of consciousness

A

Lethargy

89
Q

Shake gently to arouse, state of consciousness

A

Obtundation

90
Q

Use a painful stimuli, state of consciousness

A

Stupor

91
Q

Apply repeated painful stimuli, state of consciousness

A

Coma

Nur 4410 Peds Exam #2 (9 decks)

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