Neuro Dysfunction of the Newborn Flashcards
what is the #1 sign of neuro injurys
high pitch cry
generalized edema across the head
caput succedaneum
crosses suture lines
localized edema at one or two sides
cephalohematoma
does NOT cross suture lines
want _____ to be born ________ because of increased risk for head ______
preterm; c-section; injury
how can you tell if a neonate is having a seizure
if jerky and put hands on them and they don’t stop
- drop in HR and O2
what is the drug of choice for seizures in neonates
phenobarbital (IV or PO)
condition caused by imbalance in production and absorption of CSF in ventricular system
hydrocephalus
what is the difference between communicating and non-communicating hydrocephalus
non- communicating has an obstruction (brain tumor) and ventricles do NOT communicate
when does the posterior fontanel close
1-2mos
when does the anterior fontanel close
12-18mos
when does the suture lines close
18mos
what is the biggest complaint among parents of those who have hydrocephalus kids
personality changes
post op for VP shunt should include
keep flat for 12-24hrs
measure FOC
what are S/S of shunt malfunction
N/V, HA, lethargy, change in behavior
what are S/S of shunt infection
fever, vomiting, poor vomiting, seizure, change in behavior
the shunt pt should contact PCP no matter what when they have a
fever
for the shunt pt, what can they NOT due (for life)
play contact sports
50% of what cases can be prevented with 0.4mg of folic acid intake daily
spina bifida
failure of neural tube to close in utero
spina bifida (by week 4, neuro tube should close)
what are the 2 types of spina bifida
occult and cystica
defect is visible externally
- meningiocele
- myelomeningocele
spina bifida cystica
defect not visible externally
spinal vertebrae does NOT completely encase spinal cord
spina bifida occult
signs of spina bifida occult
skin dimple
tuft of hair
depression of skin
port wine nevi
encases meninges and spinal fluid
NOT associated with neuro defect
meningocele
encases meninges, spinal fluid, and nerves
generally see neuro defect
baby needs to be prone
myelomeningocele
pre op care of spina bifida cystica
sterile, moist, non adherent dressing (changed q2-4hrs) measure FOC keep prone prevent fecal contamination NO rectal temps report CSF immediately
post op care of spina bifida cystica
prone monitor FOC no rectal temps use latex free cart teach how to straight cath
most serious neural tube defect
both hemispheres are absent
anencephaly
what neuro defect should you perform total body cooling
hypoxic-ischemic encephalopathy
mom will report baby not moving in utero, the worse the pt gets the worse the s/s
hypoxic- ischemic encephalopathy
