Neuro Book

Question 1

**understand the different types of seizures
what nursing interventions should be done

Answer 1

partial/focal: one hem, aura, unprovoked, sudden
generalized: both hem, tonic clonic, postictal
febrile: generalized
- simple: one less than 15 min and no reoccurrences
- complex more than 15 min and reoccur
status epi: +30 min slides/15 min book, or intermittent with no recovery

left side lying
maintain air way
jaw thrust
O2
nothing in mouth
clear space
remove restrictive clothing

Question 2

**what are febrile seizures and why do they occur

Answer 2

seizure with fever over 101/38.3
due to immature neuro system
6mo-5 years

Question 3

**understand viral and bacterial meningitis, what is the treatment for each what are symptoms (pay attention to age)

Answer 3

bacterial: more dangerous, abx and dexmethosone, decrease CSF gluc
- infants: hypothermia, change in feeding, bulging or flat fontanelle, V/D
- older: fever, muscle pain, photophobia, nuchal rigidity

viral: supportive, norm CSF gluc
- abrupt onset of fever, menegial signs, malaise, V/D, upper resp s/s

Question 4

**understand how to conduct kerning and brudzinski assessment

Answer 4

kerning is brining knee up
brud is brining the neck down and knees bend up

Question 5

**what is hydrocehlapus and how is it treated

Answer 5

imbalance between CSF produced and absorbed
TX: shunt
s/s infant
- increase head circ
s/s older
- increase ICP

Question 6

** what is a VP shunt, how do we know if the shunt is working vs malfunctioning

Answer 6

passes CSF to perinetional area, r atria, pleural space, or subgaleal space
infant s/s
- nonspecific, irritability, vomiting, decrease appetite, change in sleep
older s/s
- N/V, HA, decrease loc

Question 7

**s/s of increase ICP

Answer 7

early:
diplopia
sunset eyes
N/V
pupils not reactive
change in LOC
restless

late
Cushing
seizures
fixed and dilated

Question 8

** spina bifida
meningocele
myelomeningocele

Answer 8

spina bifida: defect in 1 or more vertebrae that allows spinal cord contents to protrude

meningocele: protrusion of meningeal sac filled with CSF through a vertebral defect

myelomeningocele: malformation of spinal cord and canal

Question 9

**understand how a child with CP might present, what are goals of treatment

Answer 9

motor, hearing, vision, communication, perceptions, cognitive, or behavioral prob

provide adequate nutrition, maintain skin integrity and promote physical mobility/saftey/growth and dev

Question 10

when does the neural tube develop

Answer 10

4th week

Question 11

suture lines between skull interlock by

Answer 11

6 mo

Question 12

when are suture lines ossified

Answer 12

12 year old

Question 13

a full term infant has what nervous system

Answer 13

immature

Question 14

myelination progresses and that leads to

Answer 14

newborn reflexes disappear
- cephalocaudal direction

Question 15

lumbar puncture should be postponed for any signs of

Answer 15

herniation/ increase ICP

Question 16

with viral why do we want to use nonasprin

Answer 16

reye syndrome

Question 17

neonatal seizures apperence

Answer 17

subtule with roving eye movement, receptive blinking, sucking, lip smacking, tongue thrusting, swimming movement with arms

Question 18

bacterial men is comfy in what position

Answer 18

opisthonic

Question 19

why should pts with a shunt be careful of MRI

Answer 19

could lead to pressure issues of the shunt

Question 20

when is new shunt replaced after shunt infection

Answer 20

when CSF culture is sterile

Question 21

when can fetal surgery be performed for neural tube issues

Answer 21

26

Question 22

CP spastic

Answer 22

majority of cases
increase muscle tone, contractures, increase DTR, clonus, persistent newborn reflexes

Question 23

CP dyskinetic ~ Athetosis

Answer 23

abnormal musc tone, difficulty with fine motor, tremors

Question 24

CP dyskinetic ~ dystonia

Answer 24

muscle contraction, posturing, twitching, rigid when awake and normal to decrease when asleep

Question 25

CP ataxic

Answer 25

abnormal volume, wide gait, Dif maintaining posture, increase or decrease in tone, difficulty controlling hand and arm during reaching

Question 26

CP diet

Answer 26

increase cal and soft foods due to aspiration, increase fluids, and fiber