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Peds > neuro part 1 (3) > Flashcards

neuro part 1 (3) Flashcards

1
Q

when in gestation does the neural tube begin to form?

A

4th week

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2
Q

why is the brain and spinal cord at greater risk for injury in gestation?

A

they are formed really early on

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3
Q

describe CNS at birth

A

complete but immature

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4
Q

what cells enable receipt of nerve impulses

A

glial cells and dendrites

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5
Q

why does head circumference increase in infants and toddlers

A

brain growth

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6
Q

when does brain growth stop

A

12-15 years old

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7
Q

what is associated with the presence of infant refelxes?
a) lack of myelination
b) hypoxia
c) structural defects
d) infections

A

a) lack of myelination

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8
Q

what is the progressive covering of axons with layers of myelin or a lipid protein sheath is incomplete at birth

A

myelination

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9
Q

what accounts for progressive acquisition of fine and gross motor skills , coordination, and loss of infant reflexes in early childhood

A

myelination

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10
Q

what reflex has the baby extend the arms and fingers to form a C after being startled

A

moro

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11
Q

when does moro reflex disappear

A

6 months

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12
Q

which infant reflex is when you place a finger in the baby’s palm (not touching thumb). strong grip around finger

A

palmer grasp

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13
Q

when does the palmer grasp go away

A

3 months

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14
Q

What reflexes when you place a finger across the foot at the base of the toes, toes curl to grip the finger

A

plantar grasp

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15
Q

when does plantar grasp disappear

A

8months

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16
Q

What reflexes when you hold the infant erect and touch the top of one foot to the table or the chair, foot lifts as if to step onto the surface

A

placing reflex

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17
Q

When does the placing reflex disappear

A

several times

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18
Q

which reflexes when you hold the infant erect and touch the bottom of the foot on the surface, feet will lift in alternating pattern as if walking

A

stepping

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19
Q

When does the stepping reflex disappear

A

4-8 weeks

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20
Q

what reflexes when you place the infant supine and turn the head to one side, arm and leg on the face side extend an opposite arm and like flex, fencing position

A

tonic neck

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21
Q

When does the tonic neck reflex appear and disappear?

A

Appears at two months, disappears four to six months

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22
Q

what are spaces of connective tissue covering the brain at the junction of scroll bones which allow for brain growth

A

fontanels

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23
Q

what happens if the fontanels close prematurely?

A

It will not allow proper head growth

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24
Q

when does the posterior fontanelle close?

A

2-3 mo.

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25
Q

When does the anterior fontanel close?

A

12-18 mo.

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26
Q

Which fontanelle shows signs if there is increased intracranial pressure

A

anterior

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27
Q

brain growth continues until what age?

A

12-15

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28
Q

What is the most important indicator of neurologic dysfunction?

A

level of consciousness

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29
Q

What is the responsiveness of the minds to censor stimuli

A

consciousness

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30
Q

what are the two components of consciousness?

A

alertness
cognitive power

31
Q

Which component of consciousness is the ability to react to stimuIi?

A

alertness

32
Q

Which component of consciousness is the ability to process the data and respond either verbally or physically?

A

cognitive power

33
Q

What can cause changes in level of consciousness? select all
1. inadequate folic acid
2. teratogens
3. infection
4. substance abuse
5. trauma
6. caffeine

A

2345

34
Q

T/F?
Intracranial pressure is the force exerted by brain tissue, cerebrospinal fluid and blood within the cranial vault

A

true

35
Q

symptoms of a decline in LOC would include? Select all.
1. Slight disorientation to time and place
2. restless and fussy
3. will respond to soft verbal commands
4. Lethergy

A

124

36
Q

early clinical manifestations of increased intracranial pressure would include? Select all.
1. Headache
2. nausea and vomiting
3. Slight change in vital signs
4. peoples not as reactive or unequal
5. oriented to person, place and time and situation

A

1234

37
Q

What change in vital signs occur in the early stages of increased intracranial pressure?

A

tachycardia, Inc. temp with infection, increased in BP

38
Q

Late signs of intracranial pressure include which of the following?
1. Significant decrease in level of consciousness
2. Increased systolic blood pressure, wide pulse pressure
3. bradycardia
4. Irregular respirations
5. Fixed and dilated pupils
6. tachycardia
7. seizures

A

123457

39
Q

What are the symptoms of Cushing’s triad related to increased intracranial pressure

A
  1. increased systolic blood pressure, wide pulse pressure
  2. bradycardia
  3. irregular respirations
40
Q

which tool is used in the assessment of coma in infants and children, it enables future comparison of improvement or deterioration

A

Glasgow coma scale

41
Q

What diagnostic tests are done for alternative level of consciousness?

A
  • CBC, electrolyte, blood culture
  • toxicology, blood, urine
  • lumbar puncture
  • EEG
  • CT
  • MRI
42
Q

Therapy for alter level of consciousness

A

find cause and treat

43
Q

nursing management for altered level of consciousness

A
  • Maintain airway
  • assess/vitals
  • mouth care
  • integumentary
  • nutrition
44
Q

what are the immediate interventions for a jerking a seizure?

A
  • airway assessment
  • assess safety
  • position on side
  • suction available
  • get help
  • monitor seizure activity
  • assess LOC
  • vitals/assess after
  • administer meds
45
Q

How long is the loss of consciousness from a tonic clonic seizure?

A

1-2 mins

46
Q

which tonic clinic phase Is where the body goes stiff and rigid due to muscle contraction

A

tonic

47
Q

which phase of tonic clinic is rhythmic jerking motion of muscles

A

clonic

48
Q

which seizure is a result of diffuse electrical activity that begins in both hemispheres of the brain simultaneously

A

tonic clonic

49
Q

What kind of seizure is a tonic clonic seizure

A

generalized

50
Q

what area of the brain does a tonic clinic seizure spread?

A

cortex/brainstem

51
Q

Describe facial appearance of tonic clonic seizures?

A

eyes roll upward or deviate to the side, pupils dilate, drooling or foaming at the mouth due to secretions

52
Q

describe airway, BMR, and urinary/bowel in tonic clonic seizures

A
  • airway compromised
  • BMR rise (Inc oxygen demand)
  • urinary/bowel incontinence
53
Q

What are the two types of seizures

A

focal/partial, generalized

54
Q

what age do absence seizures occur?

A

4-10 years

55
Q

describe absence seizures?

A

Brief loss of consciousness, rarely longer than 30 seconds, usually five to 10 seconds

56
Q

How often do absence seizures occur?

A

can be 50-100/day or more

57
Q

What kind of seizures is where there is no loss of consciousness, lasts less than 30 seconds

A

simple partial

58
Q

What is another name for a simple partial seizure?

A

focal

59
Q

What kind of partial seizure is where consciousness is impaired for 30 seconds to five minutes?

A

complex partial

60
Q

What was the period following this season were a level of consciousness is decreased?

A

postictal phase

61
Q

What is a prolonged continuous seizure of 15 minutes or intermittent seizures lasted more than 15 minutes without a full recovery between them?

A

status epilepticus

62
Q

Which of the following is true about febrile seizures? Select all.
1. Rapid rising temperature
2. occurs between nine months and five years old
3. always needs treated long term
4. family history
5. increased risk of future febrile procedures if they have one

A

1245

63
Q

when are febrile seizures treated?

A

when they are repeated, use anticonvulsants, not treated if it only occurred once

64
Q

when can ibuprofen be used?

A

when older than 6 months

65
Q

What diagnostic testing for seizures?

A
  • CBC, elec
  • urine/blood/lumbar puncture
  • lead level, urine/blood toxicology
  • inborn errors of metabolism
  • medication blood levels
  • EEG
  • MRI/CT
66
Q

what kind of drug therapy is preffered to treat seizures (decreases side effects)

A

mono-therapy (one drug)

67
Q

how effective is mono-therapy for seizures, and when would a second med be added?

A

effective for 50% of new onset seizures, second med added if poor control

68
Q

what classifies intractable seizures

A

continues to have seizures with 3+ meds

69
Q

what are options of therapy for intractable seizures (3)

A
  1. surgery (resections)
  2. vagal nerve stimulator (pulse generator, regulate seizures)
  3. ketogenic diet (inc. fat, adequate protein, dec. carbs)
70
Q

when will someone on seizure medications go under med withdraw attempt?

A

after being seizure free for 2 years or longer

71
Q

what seizure med is teratogenic

A

valproic acid

72
Q

T/F?
It is safe to place a tongue blade into a child’s mouth to prevent them biting their tongue while they are having a seizure?

A

false

73
Q

what does oxygen need to be at during a seizure

A

> 95%

74
Q

what meds are given during seizure

A

rectal diazepam

Peds (30 decks)

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