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PNLE REVIEW FLASHCARDS 💯🫵💅 > PEDIA - NEURO DISORDERS > Flashcards

PEDIA - NEURO DISORDERS Flashcards

1
Q

Normal ICP?

A

5-15 mmHg

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2
Q

value of increased ICP?

A

more than 15 mmHg

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3
Q

value of life-threatening ICP

A

more than 20 mmHg

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4
Q

triad for increased ICP?

A

Cushing’s triad
(Hyper Brady Brady)

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5
Q

What is Cushing’s triad?

A

Hypertension
Bradycardia
Bradypnea

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6
Q

What is Shock’s triad?

A

Hypotension
Bradycardia
Bradypnea

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7
Q

normal pulse pressure?

A

30-40 mmHg

more than 40 = widened
less than 30 = narrowed

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8
Q

EARLY SIGN of increased ICP? (INFANT)

A

high-pitched/ shrill cry

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9
Q

EARLY SIGN of increased ICP? (CHILD)

A

irritability/agitation

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10
Q

EARLY SIGN of increased ICP? (ADULT)

A

restlessness

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11
Q

EARLY SIGN of increased ICP? (GERIA)

A

confusion

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12
Q
A
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13
Q

diamond-shaped fontanel?

A

anterior

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14
Q

triangular-shaped fontanel?

A

posterior

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15
Q

anterior fontanel takes (faster or slower) to close? how long?

A

slower/ longer

12-18 month

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16
Q

posterior fontanel takes (faster or slower) to close? how long?

A

faster

2-3 months

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17
Q

bulging fontanels due to increased ICP is aggravated by what action of a child?

A

crying :((

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18
Q

If a pediatric pt has increased head circumference, what must be available at bedside?

A

tape measure
(measure qshift/ q8)

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19
Q

INITIAL SIGN of increased ICP?

A

headache

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20
Q

s/s of increased ICP;
due to compression of medulla > compression of CTZ > cerebral edema

A

projectile/ forceful vomiting

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21
Q

visual changes/ s/s of increased ICP?

A

diplopia/ double vision

increased ICP = increased IOP

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22
Q

normal assessment of pupils/ pupillary response?

A

PERRLA
(pupil equally round and reactive to light and accomodation)

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23
Q

pupillary changes; uneven pupils?

A

anisocoria

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24
Q

pupillary changes; dilated pupils are due to what complication?

A

shock

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25
pupillary changes; constricted pupils are due to what complication?
narcotic overdose
26
pupillary change due to increased ICP?
sunset eyes pressure in the brain pushes the eyes downward.
27
an important indicator of health in pediatric patients?
weight weight gain is normal!! weight loss is abnormal!!
28
seizures in increased ICP are caused by what? (2 causes)
1. increased ICP > increased neuronal impulses > erratic transmission of electrical impulses > seizure 2. vomiting > decreased fluid levels > dehydration > increased temp > seizures and convulsions
29
position of a patient with increased ICP?
semi fowler's/ HOBE drain CFS by gravity decrease CSF = decrease ICP
30
can a patient with increased ICP cough/ bear down?
NO! increases ICP
31
in increased ICP, fluids should be (limited/ restricted) ?
limited only > restrict will cause DHN 1,200-1,500 mL/day
32
normal amount of fluid intake?
2,000-3,000 mL/day
33
pharmacotherapy for increased ICP? (5)
diuretics decadron (dexamethasone) anticonvulsants antacids anticoagulants
34
diuretic that has a localized effect
loop diuretic (Lasix)
35
diuretic that has a generalized effect?
osmotic diuretic (Mannitol)
36
in giving diuretics, watch out for?
hypokalemia diuretics are potassium-wasting!!
37
medication given in increased ICP to prevent cerebral edema?
decadron: dexamethasone steroids, anti-inflammatory
38
medication given in increased ICP to release excess fluid?
diuretics
39
medication given in increased ICP to prevent seizure episodes?
anticonvulsants
40
medication given in increased ICP to neutralize acidity?
antacids increased stress > increased hydrochloric acid + decadron > gastric irritation > easily ulcerated
41
2 types of antacids and their side effects?
Magnesium hydroxide > diarrhea Aluminum hydroxide > constipation
42
2 types of anticoagulants and their routes?
Heparin > IV/subq Warfarin > Oral
43
what blood test to check with heparin administration?
partial thromboplastin time (PTT) (N=25-35 secs) therapeutic range: 1.5-2.0x normal value
44
what blood test to check with warfarin administration?
prothrombin time (PT) (N=10-13 secs) therapeutic range: 1.5-2.0x normal value
45
antidote for heparin?
protamine sulfate
46
antidote for warfarin?
vitamin k
47
medications contraindicated in pt with increased ICP?
opiates and sedatives depressants > cushing's triad > respi and cardiac depression
48
generalized type of seizure (head to toe)
grand mal
49
period DURING a seizure where there are mild to severe contractions?
tonic clonic
50
position during a seizure (tonic clonic)?
flat/ supine
51
period AFTER a seizure/ exhaustion phase
post ictal
52
position after a seizure?
side-lying
53
type of seizure with a blank facial expression, automatism, and lip smacking?
petite mal/ absent/ blank seizure
54
type of seizure which starts with tonic clinic and progresses into a grand mal seizure
jacksonian seizure
55
type of seizure common in adults; mental clouding and intoxication
psychomotor seizure
56
type of seizure most common in pedia; aka under 5 seizure
febrile seizure progressive increase in temp > may cause convulsions
57
most dangerous type of seizure; up to 30 mins of on and off/ continuous seizure
status epilepticus
58
seizure medication hydantoins: phenytoin causes what side effects? (2)
gingival hyperplasia (HE: soft bristle toothbrush, meticulous oral care) pinkish red urine (HE: inform S/O)
59
medication used to decrease seizure episodes?
benzodiazepines/ anxiolytics
60
seizure medication used for refractory seizure and prevents reoccurrence?
iminostilbenes (carbemapizine)
61
seizure medication given ONLY AS A LAST RESORT due to S/E hepatotoxicity
valproates/ valproic acid never given in pregnancy! can cause neural tube defects
62
surgical removal/ resection of cranial nerve involved in seizure activity?
neurectomy
63
diagnostic test used to detect bacterial meningitis?
lumbar puncture for CSF analysis
64
disease caused by infection of the meninges
bacterial meningitis
65
position of the pt. during lumbar puncture?
C-shape/ fetal/ genupectoral/ knee-chest position
66
causative agent of bacterial meningitis?
neisseria meningitides
67
CSF analysis result of pt with bacterial meningitis?
cloudy in color (increased WBC and protein content) protein is a byproduct of bacteria
68
management of bacterial meningitis?
antibiotic therapy
69
S/S of bacterial meningitis: pain in the hamstring, back, and neck when flexed?
+ Kernig's sign *think (K)nee = Kernig*
70
S/S of bacterial meningitis: pain in the back, and neck when flexed?
+ Brudzinski sign *think (B)atok = Brudzinski*
71
S/S of bacterial meningitis: stiffness in the neck?
nuchal rigidity (move body and head as one unit)
72
S/S of bacterial meningitis: arching of the back
opisthotonus
73
how do you position an opisthotonus pt.?
side-lying
74
head trauma where there is jarring of the brain causing loss of consciousness?
concussion
75
head trauma where there is extravasation of blood/ bruising causing structural alteration?
contusion
76
in the PH, infant car seats for children < 3y/o should be ___
rear-facing (protect the spine)
77
in the PH, infant car seats for children > 3y/o should be ___
front/ forward-facing
78
most important prognostic indicator in children after a head trauma?
loss of consciousness
79
immediate nsg action for a pt. with a cervical neck injury?
immobilize (to prevent further damage)
80
sng action for a pt. with no cervical neck injury?
HOB elevated to decrease ICP with gravity low fowler's (30 degrees)

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