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Kol- Pedes > Neuro Disorders > Flashcards

Neuro Disorders Flashcards

1
Q

3 forms of spina bifida

A

Spina bifida occulta
Meningocele
Myelomeningocele

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2
Q

Type of spina bifida:
‣ tuft of hair present, dimpling at base of spine
‣ no protrusion of spinal nerves, but missing bone

A

oculta

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3
Q

Type of spina bifida:

Protrusion containing meninges and spinal fluid ,,, NO nerves

A

Meningocele

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4
Q

Type of spina bifida,,,

Protrusion containing meninges, spinal fluid, and nerves

A

Myelomeningocele

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5
Q

What is the general name for the disorder that causes neural tube defects affecting g the CNS

A

Spina bifida

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6
Q

Spina bifida increases risk of what allergy?

A

Latex!

*can be life threatening allergic reaction

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7
Q

Spina bifida increases risk of what disorder that requires shunting at it?

A

Hydrocephalus

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8
Q

Bladder and bowel issues/paralysis with which types of spina bifida?

A

Meningocele and Myelomeningocele

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9
Q

Can we take rectal temps on spina bifida patients?

A

Heck no!

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10
Q

What kind of dressing goes over lower back of spina bifida patient?

A

Sterile moist dressing initially, change ever 2 hours

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11
Q

What position do we place new born spina bifida patient in?

A

Prone

Avoid pressure on sac

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12
Q

What kind of hold is recommended for spina bifida newborn?

A

Football hold — avoid pressure on sac

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13
Q

Can spina bifida babes be born vaginally?

A

No! C section

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14
Q

When is surgery done to repair spina bifida site after birth?

A

Within 24-48 hours of birth

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15
Q

Long term considerations for spina bifida

A

risk for ineffective ADL/ impaired elimination/ mobility
◦ education: in and out every 4 hours
◦ OT to help with bowel training
◦ ROM exercises

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16
Q

Is hydrocephalus common in spina bifida patients?

A

Yes! 90-95% have it

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17
Q

This disorder is an imbalance in the PRODUCTION and/or ABSORPTION of the CSF

A

Hydrocephalus

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18
Q

What does hydrocephalus do to fontanel?

A

Accumulation of blood in ventricles causes bulging of the fontanels

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19
Q

Post op consideration for VP (ventricular peritoneal) Shunt (think: positioning)

A

position change follows Dr. orders
‣ do not elevate too fast –> fluid drain too quickly –> injury to brain
‣ lay child flat on his or her nonsurgical side to prevent rapid reduction in intracranial fluid

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20
Q

S/s if increased icp in infant

A 
◦ bulging fontanel 
	◦ increase in head circumference 
	◦ high pitched cry
	◦ lethargic
	◦ vomiting
	◦ widening of cranial suture lines
21
Q

S/s of increase ICP IN CHILD

A 
◦ headache
	◦ lethargic
	◦ n/v
	◦ double vision
	◦ decreased LOC 
	◦ seizure
22
Q

Disorder causing movement, muscle control, and posture deficits caused by hypoxia to the brain

A

Cerebral palsy

23
Q

Most common disability of childhood to effect the movement

A

Cerebral palsy

24
Q

4 types of cerebral palsy

A

Spastic
Dyskinentic
Ataxic
Mixed

25
Q

Type of CP: hypertonicity- muscles tight, increased reflexes, clonus, poor control with balance/ posture/movement, fine/gross motor difficulties, pyramidal, crouched gait with scissoring motion of legs, Babinski reflex

A

Spastic

26
Q

Type of CP:

involuntary jerking, slow worm like movements, non-spastic, extrapyramidal, slow twisting movements, drooling and speech impairment

A

Dyskinetic CP

27
Q

Type of CP:

wide based gait, difficulty with coordination, can’t do repetitive motions well, difficulty with purposeful movement like reaching for an object

A

Ataxic CP

28
Q

When is CP diagnosed

A

• diagnosed in infancy when child fails to meet milestones of development

29
Q

Interventions for CP

A

◦ no cure but can use OT/PT/ surgery/equipment/meds like anti anxiety/seizure meds to manage it
• Safety : protective equipment- helmet/pads, safe toys preventing aspiration, position child upright with feeding, educate parents

30
Q

Most common type of seizure in pedes? What causes it?

A

Febrile — temp >104

31
Q

Safety considerations for seizure

A

◦ suction/oxygen
◦ bed free of things that can injure them
◦ pad side rails
◦ position on side during seizure –> prevent aspiration of secretions
◦ bed locked and low
◦ loosen restrictive clothing
◦ do not try to restain/put anything in mouth
◦ stay with child
◦ note onset/characteristics

32
Q

What is meningitis?

A

Infection of the nervous system
•Affects covering of the brain and spinal cord (meninges)
•Medical emergency – life threatening infection

33
Q

Is meningitis chill or like a big deal?

A

Medical emergency= life threatening!

34
Q

Tonic phase of seizure =

A

Stiffening 10-20 seconds

35
Q

Clonic phase of seizure =

A

Jerking, 30-50 seconds

36
Q

Postictal phase of seizure

A

Limp body, semiconscious, after tonic and clonic, lasts 30 min

37
Q

2 weird types of seizure disorders from ATI

A

West syndrome- onset 3-7 mont, tested with ACTH, single sudden seizure of cluster of up to 150
Lennox- gastaut syndrome- mixture of seizure with cognitive deficits

38
Q

S/s of meningitis in infant/child

A

• infant= low temp, not feeding, lethargy, bulging fontanels
• Severe headache
• stiff neck
• older kids =sudden high fever
• photosensitivity
• altered mental status
• rash = specific type of bacteria- can die within hours! very serious
•Kernig’s sign
◦ Flex hip and knee 90° - positive if child cannot extend knee from pain
•Brudzinski’s sign
◦ Flexion of neck causes involuntary flexion of knee and hip

39
Q

Re: meningitis sign

◦ Flexion of neck causes involuntary flexion of knee and hip
A

Brudzinski’s sign

40
Q

Re meningitis sign:

◦ Flex hip and knee 90° - positive if child cannot extend knee from pain

A

Kernigs sign

41
Q

2 types of meningitis

A

Viral ( aseptic) and bacterial ( septic)

42
Q

Which type of meningitis is highly contagious and requires droplet precautions

A

Bacterial

43
Q

When do we give Abx in relation to lumbar puncture?

A

Before LP!

44
Q

Worst kind of meningitis?

A

Bacterial

45
Q

Positioning for lumbar puncture - during and after

A

◦ Proper positioning – hips and knees flexed
‣ Infant – chin to chest and knees to abdomen- check resp. status in this position
◦ Flat in bed after procedure

46
Q

Need to differentiate meningitis from ______ ______

A

Reye’s syndrome

Can cause liver and neuro and looks like meningitis

47
Q

Reye’s syndrome occurs when….

A

You use aspirin with viral infection

Exception=COME BACK TO THIS. WE JUST LEARNED ABOUT IT

48
Q

Signs of increase ICP re: head injury

A 
◦ Slow, sluggish pupil response, increased sleeping
	◦ Infant – bulging fontanels
	◦ Bradycardia (late sign) 
	◦ irritable, fussy
	◦ emesis 
	◦ changes in mental status/LOC/ coma
49
Q

Education re head injuries

A

• Preventative education is key: helmets, seat belt, shaken baby syndrome

Kol- Pedes (16 decks)

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