Neuro Tube Defects & Congenital Conditions Flashcards
What protein will be high with spina bifida
Fetal alpha protein
What is a neuro tube made up of?
Brain and spinal cord develop as a groove that folds over to become a tube
Spina bifida occulta s/s
Hidden, bowel&bladder dysfunction, back pain, leg weakness, scoliosis
Spina bifida meningocele s/s
Severe type of spina bifida, meninges protrude, fluid filled bulge under the skin
Meningomyelocele spina bifida s/s
Tissues & nerves may be exposed, neuro disabilities rt location, Sensory or motor loss after surgery, no bowel or bladder control, flaccid lower body, won’t ever walk
When do you need to reform surgery for spina bifida and why
Within the first 48 hours to prevent infection and further injury
Hydrocephalus
Excessive accumulation of fluid on the brain, associated with spina bifida, abnormal enlargement of ventricles in brain
S/s of hydrocephalus in infants
Abnormal head, tense bulging fontanel, separation of skull bones, vomiting, irritability, seizures
S/s of hydrocephalus in toddlers/older children
HA, N,V, blurred vision, unstable balance, sleepiness, poor concentration, difficulty waking up
S/s of hydrocephalus in young middle aged children
HA, bladder problems
S/s of hydrocephalus in old person
Shuffling gait
Therapeutic management of hydrocephalus and what do they do
Vp shunt/va shunt, endoscopic third ventriculostomy. They divert fluid
Endoscopic third ventriculostomy
Creation of a new pathway between 3rd and 4th ventricles
Nursing things you have to do for hydrocephalus
Measure head circumstance and ear to ear, asses for s/s of ICP/infection
S/s of ICP in babies
Tense fontanel a, increased head circumference, decreased LOC, poor sucking, vomiting
S/s of infection in babies
Fever, increased pulse, general malaise, signs of meningitis, high pitched cry
What should nurse do after shunt is placed
Position to avoid pressure on valve, keep HOB elevated 30 degrees or less, resume fluids gradually after NPO status, Medicare for pain, follow up appointments
Parent teaching after shunt is placed
Don’t lay head on shunt because it’ll drain all out, comfortable position for feeding, promote bonding, position changes of head, G&D delay signs, shunt malfunction, the more you control spoofed of ICP the better chance they will have a normal life
When does Cerebral palsy appear
Infancy or early childhood
What does cerebral palsy effect
Permanently effects movement/muscle coordination
How does early treatment effect cerebral palsy
It can improve capabilities
Is Cerebral palsy progressive?
No, it’s not linked to intellectual function either
Cerebral palsy risk factors
Premature birth, LBW, lack of nutrients, lack of growth factors, rh or ABO incompatibility, maternal infections, alcohol exposure, smoking, drugs
What can progress overtime with CP?
Muscle spasticity
Early s/s of CP if s/s show before 18 months
Delayed motor development (not meeting milestones), abnormal muscle tone(will either hypotonia or hypertonia)
Hypotonia
Decreased muscle tone
Hypertonia
Stiff or ridged muscle tone
Prevention of CP
Immunization against measles for all women prior to pregnancy, bilirubin levels, reduce risk of virus exposure, avoid unnecessary X-ray, drugs, control anemia, Nutritional deficiencies
Treatment related to other complications of CP
G tube placement for feeding, fundoplication
Anti seizure meds and intrathecal baclofen (ITB)-GABA receptor agonist are used for?
CP
Fundoplication
Keeps CP patients from vomiting
