Neuromuscular Dysfunction

Question 1

normal blood sugar of infant

Answer 1

first 12 hours: 40

12+: 45-60

Question 2

Cerebral Palsy Causes

Answer 2

pre-existing prenatal brain abnormalities (70% of cases)

Question 3

Cerebral Palsy Clinical Manifestations

Answer 3

1. spastic (premature)
2. athetoid
3. cerebral hypoxia
4. combo

Question 4

Spastic CP

Answer 4

increased muscle tone
flexor muscles used
impairment of fine and gross motor skills
wheelchair bound
scissoring motions

Question 5

Athetoid CP

Answer 5

involuntary movements of the face and extremities
increased with stress and adolescence
normal deep tendon reflex

Question 6

Dyskinetic

Answer 6

involuntary jerking movements

Question 7

Dystonia

Answer 7

decrease in muscle tone
floppy baby
flacid

Question 8

Athetosis

Answer 8

slow movements
increased drooling
speech issues

Question 9

Ataxic CP

Answer 9

wide gait
legs spread very wide
disturbed coordination 
cannot guage distance 
back and forth movement of the eyes (dancing eyes)

Question 10

Mixed CP

Answer 10

flexed
no fine/gross movements
poor slow speech
drooling 
grimacing

Question 11

CP diagnosing

Answer 11

prenatal: where they premature
newborn: assess for reflexes. floppy baby
MRI: check for lessions in the brain
EEG: check for electric activity for seizures

Question 12

Hypotonia

Answer 12

FLOPPY BABY SYNDROME

decreased muscle tone

Question 13

CP Treatment

Answer 13

establish communication and self help

gain optimal appearance and optimal motor function

Question 14

Magnesium Sulfate

Answer 14

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

Question 15

Musculoskeletal Treatments

Answer 15

Ankle Foot Orthosis: splints given for hands/feet to maintain good position
wheelchairs
surgical interventions

Question 16

CP Medications

Answer 16

trying to treat muscle spams
Baclofen: muscle relaxant (sfx diaphoresis)
Diazepam: sfx dizzy/drowsy
Botulinum: botox injection to decrease spasticity

Question 17

Baclofen

Answer 17

injected with a catheter pump

sfx: hypotonia (too relaxed/limp)

Question 18

Anti-Epileptic Drugs

Answer 18

treats seizures associated with CP

Question 19

CP Prognosis

Answer 19

normal intelligence
decreased bone growth
half of people live independently
frequent flyers to the hospital

Question 20

Nursing Considerations for CP

Answer 20

impaired physical mobility
self care deficit
risk of injury
impaired verbal communications

Question 21

Myelomeningocele Spina Bifida

Answer 21

worst kind of spina bifida
abnormality of the embryonic spinal cord
can be extensive to minimal
folic acid helps to decrease

Question 22

Neural Tube Defects

Answer 22

doesnt close at 28 days after conception
degree depends on where the sac sticks out of the vertebral column
common: lumbar, lumbosacral

Question 23

Myelomeningocele Symptoms

Answer 23

Hydrocephalus: 
irritable 
sunken eyes
 bulging fontanelles
80-90% of all cases

Question 24

Care of the Myeolomeningocele Sac

Answer 24

keep it moist, care for it
do not lay the infant on their backs
Prevent skin breakdown

Question 25

Diet for Normal Bowel Evac

Answer 25

fiber

fluids

Question 26

MACE

Answer 26

surgery to create a channel from appendix to proximal end of colon. should irrigate every 1-2 days

Question 27

Early Treatment of Myelomeningocele Sac

Answer 27

Early surgical closure of the myelomeningocele sac through fetal surgery

Question 28

Folic Acid

Answer 28

take regular doses during childbearing ages

Question 29

Spina Bifida and Latex

Answer 29

20-40% have a latex allergy

Question 30

foods associated with latex

Answer 30

banana
kiwi
chestnuts
avocado

Question 31

Anaphylaxis (Type I)

Answer 31

pink raised areas, hives, itching

onset is immediate to 1 hour

Question 32

Type IV latex reaction

Answer 32

remove the latex source
itching, skin breakdown
peeling