Neuro Dysfunction of the Child Flashcards
if the pupils are dilated 5+ what does this indicate
brain stem damage
if pt has sudden appearance of fixed/dilated pupils what should be done
stay with pt and hit call light immediately
pull to the core
dysfunction of cerebral cortex or lesions above brainstem
decorticate (flexion)
majority of difference is in arms
dysfunction at midbrain or lesions to brainstem
last sign before brain deterioration
decerebrate (extension)
CM of ICP
HA vomiting personality changes irritability fatigue Infants: tense, bulginf fontanel separated sutures high pitch cry increased FOC distended scalp veins setting sun sign
what is late sign of ICP
bradycardia
what is normal ICP
<15
what medication reduces ICP by promoting rapid excretion of Na by the kidneys and works within 1-5 min
mannitol
how should you care for an increased ICP pt
HOB up (at least 30) pain control minimal stimulaiton suctioning contraindicated generally need cooling blanket stool softeners
what are halmarks of concussion
confusion and amnesia
if there is a basilar skull fracture what should you NOT do
do NOT place NGT you can do OGT instead
what are s/s of basilar skull fx
sub q bleeding in posterior neck
raccoon eyes
blood around tympanic membrane
clear CSF draining from nose or ear
blood accumulates between dura and skull
epidural hemorrhage
bleeding between dura and cerebrum
subdural hemorrhage
inflammation of the membranes covering the brain and spinal cord (medical emergency)
bacterial meningitis
what is a sign specific to bacterial meningitis
nuchal rigidity
kerning sign- flex the knee and try to extend
brudzinski sign- flex head and knee or hips flex
where is a lumbar puncture done
L3-L5
decreased glucose
positive gram stain
turbid or cloudy urine
bacterial meningitis
normal glucose
negative gram stain
clear urine
viral meningitis
how can meningitis be prevented
Hib vaccine
inflammatory process of the CNS resulting in inflammation of the brain
encephalitis
what typically causes encephalitis
virus
if encephalitis caused by herpes simplex virus what medication is given
acyclovir
what is the cardinal sign a child has rabies
hydrophobia= attempts at swallowing cause spasm of pharynx, neck, and diaphragm
if a child has rabies how many immunizations will they receive within 28 days
6
when a pt gets bit by rabid animal, why is suturing avoided
because you don’t want to enclose it inside body (clean with soap and water)
a NON progressive disorder of muscle control or coordination
cerebral palsy
is there a cure for cerebral palsy
no it is permanent
acute demyelination with a progressive, usually ascending flaccid paralysis
guillian barre syndrome
what is the hallmark symptom of guillan barre
acute peripheral motor weakness (paralysis usually occurs 10 days after nonspecific viral infection)
