Neuro PowerPoint Flashcards
nerves are covered by
meninges
when is nervous system formed
first trimester
12 wks
any insult can cause CNS malformation in gesation
- what is some eamples
decrease blood circulation
maternal HTN
illness
bleeding
when are nerve cells matured
4 years
when does the brain stop growing
21-25 years
when mylenation is increased what is decreased
primary reflexes
- tonic neck, moro, root
when should tonic neck, root, and moro be gone
6 mo
when mylenation occurs what increases or improves
fine and gross motor
why are the cranial bones not completely ossified
allows for brain growth
when does the post fontanelle close
2-3 mo
when does the ant fontanelle close
12-18 mo
the skull and brain grow and develop rapidly during childhood so infants and young children are at higher risk for
injury
muscle around neck and spinal cord is not fully developed so head is
heavy
are the vertebrae completely ossified
no
when do stuture lines between skull bones close
age 12
top heavy and excessive spinal mobility puts them at risk for
falls and shaken baby syndrome
absent seizures
staring blankly
what is the most important indicator of neurological dysfuncton
LOC
decorticate
flexor, rigid, lesions above the brain stem and cortical spinal tract
what is contraindicated in increase ICP
spinal tap
early signs of increase ICP
headache
visual changes
N/V
pupils unequal or slow
early signs of increase ICP
- infants
increase head circumference
bulging fonatalle
separating of sutures
late signs of increase ICP
LOC cecrease
Cushing triad
- Brady
- irregular resp
- widening pulse pressure
fix and dilated pupils
hypertension
late signs of increase ICP
- intants
sunset eyes
scalp veins proturding
pos babinski
what is a seizures
abonormal electrical discharge from the Brian that causes involuntary movement and behavior
different types of seizures
absent
partial
generalized
febrile
absent seizure
lip smacking and twictchin
loss of LOC
partial seizure
one side affected and opposite side will have symptoms
depend on location of insult
generalized
diffuse electrical activity on both hems, entire body involved
febrile
over 101 or 38.3
6mo to 5 year
rarely occur more than once in 24 hour
why do febrile seizures occur
due to Childs immature nervous system
partical s/s
abrupt start
unprovoked
aura
generalized s/s
aura
tonic clonicto
tonic
contraction
clonic
extension
staus epi
acute lasts over 30 min
check lytes, bp, and bs
what is common for preschool and 2 year old to do in post ictal
cry
nursing management for seizure
maintain airway
don’t put anything in mouth
left side
clear space around
meds: phenobarbital, Ativan, keppra
AED: Vtach
what is important to educate about seizure meds
dose may change as child ages or metabolism increases
hydrocephalus
spinal fluid is unable to go down leading to increase ICP
cause of hydrocephalus
intraventricualr hemmorgae
cari malformation
TBI
tumor
meningits
hydrocephalus tx
shunt
what is a shunt
drains CSF into abdomen with a one way valve
what is more common non communicating hydrocephalus or communicating hydrocephalus
non communicating
meningitis
inflammation of meningitis covering brain and spinal cord
bacterial meningitis
more sequela - damage
more dangerous
can be 2ndary
why can bac meningitis occur 2ndary
children bones are not ossified so the sinus is a large cavity and provides large area for growth and spread
viral meningitis s/s vs bac
same as bacterial
viral meningitis sequeala?
no
meningitis infant
fever
poor feeding
vomiting
irritability
seizures
high pitch cry
bulging fontanelle
nuchal rigidity
meningitis older
s/s abrupt
fever
chills
HA
vomiting
alertation in sensorium
irrituability
agitated
photophobia
seizure
coma
nuchal rigidity
- pos kernig and budunzki
kernig
knee up and resistance or pain when fully extended
brudskinski
head down to chest and knees bend and come up
lumbar puncture for bacterial
decrease gluc
increase protein
lumbar puncture for viral
normal to high gluc
normal to low protein
tx bac meningitis
antibiotics
tx viral meningitis
antibiotics until bacterial is ruled out
supportive
- dark room
- decrease stim
- minimal noise
main goal of hydrocehlapus
reduce ICP
preserve CNS function
t/f a shunt infection is a medical emergency
yes
s/s of shunt malfunction
increase ICP
worsening neuro status
change in LOC
early s/s of shunt issue
diplopia
ha
n/v
vertigo
vs changes
non reactive pupils
sunsetting eyes
change in LOC
early s/s of shunt issue
- infant
diplopia
ha
n/v
vertigo
vs changes
non reactive pupils
sunsetting eyes
change in LOC
*irritability
bulging font
wide sutures
dilated scalp veins
high pitch cry
late sign of shunt malformation
decrease in LOC
seizures
cushings triad
fixed and dilated
incidence of shunt infection/malformation
80% of children have infection with in 6 mo of placement
how do we assess infants for hydrocephalus
measure and compare head circumference
post op common complication after shunt
vomitting since ICP is being released rapidly
myelocele
fluid protruding
meningocele
nerves proturidung
meningomycelocele
fluid and nerves
why might kids with neural tube defects have latex allergies
multiple surgical produedures
nursing considerations for neural tube defects
prone position
- can’t have anything putting pressure on sac
transfer
moist sterile gauze over topw
will there be paralysis below defect for neural tube issues
yes
when is neural tube fixed
24-48 hours
post op management of neural tube
I&O
- 12-24 hour after surgery has decrease output and want to make sure it reestablishes
prone
keep diaper away
watch for infection
PROM = PT
nursing considerations for neural tube
increase fiber and fluid due to risk for constipaiton
caloric intake since at risk for obesity
immunizations
seizure disorder after vaccination: normal
increase protein and iron
UTI
if you are straight Cath yourself do you have to be sterile
no
CP characterized by
early onset and impaired movement and posture
what is the most common permeant physical disability in childhood
CP
s/s of CP
poor head control
stiff of rigid limbs
arching back
floppy tone
unable to sit w/o support at age 8 mo
persistent primitive infantile reflexes
earliest cue of CP
moro beyond 4 mo
tonic neck belong 6 mo
behavior s/s of CP
no smiling by age 3
feeding difficulties
what type of seizure can look like daydreaming
absence
when do we need to check electrolytes, BS, and ABG, temp and BP for status epi
15 min
to help maintain airway what might be helpful during a seizure
jaw thrust
what is the first line defense for seizures
benzo
parent education for seizure meds
do not stop
what gender more likely has issues with neural tube
girls
spinda bifida
defect that occurs in one or more vertebrae and allows spinal cord to protrude
spina bifida nursing dx
high risk for infection
bowel incontinence
altered urianry elimination
high risk for ineffective coping
self esteem disturb
