Neuromuscular Dysfunction Flashcards
normal blood sugar of infant
first 12 hours: 40
12+: 45-60
Cerebral Palsy Causes
pre-existing prenatal brain abnormalities (70% of cases)
Cerebral Palsy Clinical Manifestations
- spastic (premature)
- athetoid
- cerebral hypoxia
- combo
Spastic CP
increased muscle tone flexor muscles used impairment of fine and gross motor skills wheelchair bound scissoring motions
Athetoid CP
involuntary movements of the face and extremities
increased with stress and adolescence
normal deep tendon reflex
Dyskinetic
involuntary jerking movements
Dystonia
decrease in muscle tone
floppy baby
flacid
Athetosis
slow movements
increased drooling
speech issues
Ataxic CP
wide gait legs spread very wide disturbed coordination cannot guage distance back and forth movement of the eyes (dancing eyes)
Mixed CP
flexed no fine/gross movements poor slow speech drooling grimacing
CP diagnosing
prenatal: where they premature
newborn: assess for reflexes. floppy baby
MRI: check for lessions in the brain
EEG: check for electric activity for seizures
Hypotonia
FLOPPY BABY SYNDROME
decreased muscle tone
CP Treatment
establish communication and self help
gain optimal appearance and optimal motor function
Magnesium Sulfate
given for any child who is premature
given within 2 hours prior to delivery and stopped at birth
EVIDENCE shows that giving this decreases the risk of cerebral palsy in newborns
Musculoskeletal Treatments
Ankle Foot Orthosis: splints given for hands/feet to maintain good position
wheelchairs
surgical interventions
CP Medications
trying to treat muscle spams
Baclofen: muscle relaxant (sfx diaphoresis)
Diazepam: sfx dizzy/drowsy
Botulinum: botox injection to decrease spasticity
Baclofen
injected with a catheter pump
sfx: hypotonia (too relaxed/limp)
Anti-Epileptic Drugs
treats seizures associated with CP
CP Prognosis
normal intelligence
decreased bone growth
half of people live independently
frequent flyers to the hospital
Nursing Considerations for CP
impaired physical mobility
self care deficit
risk of injury
impaired verbal communications
Myelomeningocele Spina Bifida
worst kind of spina bifida
abnormality of the embryonic spinal cord
can be extensive to minimal
folic acid helps to decrease
Neural Tube Defects
doesnt close at 28 days after conception
degree depends on where the sac sticks out of the vertebral column
common: lumbar, lumbosacral
Myelomeningocele Symptoms
Hydrocephalus: irritable sunken eyes bulging fontanelles 80-90% of all cases
Care of the Myeolomeningocele Sac
keep it moist, care for it
do not lay the infant on their backs
Prevent skin breakdown
