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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
Q

pupillary changes; constricted pupils are due to what complication?

A

narcotic overdose

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26
Q

pupillary change due to increased ICP?

A

sunset eyes

pressure in the brain pushes the eyes downward.

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27
Q

an important indicator of health in pediatric patients?

A

weight

weight gain is normal!! weight loss is abnormal!!

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28
Q

seizures in increased ICP are caused by what? (2 causes)

A
  1. increased ICP > increased neuronal impulses > erratic transmission of electrical impulses > seizure
  2. vomiting > decreased fluid levels > dehydration > increased temp > seizures and convulsions
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29
Q

position of a patient with increased ICP?

A

semi fowler’s/ HOBE

drain CFS by gravity
decrease CSF = decrease ICP

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30
Q

can a patient with increased ICP cough/ bear down?

A

NO! increases ICP

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31
Q

in increased ICP, fluids should be (limited/ restricted) ?

A

limited only > restrict will cause DHN
1,200-1,500 mL/day

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32
Q

normal amount of fluid intake?

A

2,000-3,000 mL/day

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33
Q

pharmacotherapy for increased ICP? (5)

A

diuretics
decadron (dexamethasone)
anticonvulsants
antacids
anticoagulants

34
Q

diuretic that has a localized effect

A

loop diuretic (Lasix)

35
Q

diuretic that has a generalized effect?

A

osmotic diuretic (Mannitol)

36
Q

in giving diuretics, watch out for?

A

hypokalemia
diuretics are potassium-wasting!!

37
Q

medication given in increased ICP to prevent cerebral edema?

A

decadron: dexamethasone
steroids, anti-inflammatory

38
Q

medication given in increased ICP to release excess fluid?

39
Q

medication given in increased ICP to prevent seizure episodes?

A

anticonvulsants

40
Q

medication given in increased ICP to neutralize acidity?

A

antacids

increased stress > increased hydrochloric acid
+
decadron > gastric irritation > easily ulcerated

41
Q

2 types of antacids and their side effects?

A

Magnesium hydroxide > diarrhea
Aluminum hydroxide > constipation

42
Q

2 types of anticoagulants and their routes?

A

Heparin > IV/subq
Warfarin > Oral

43
Q

what blood test to check with heparin administration?

A

partial thromboplastin time (PTT)
(N=25-35 secs)
therapeutic range: 1.5-2.0x normal value

44
Q

what blood test to check with warfarin administration?

A

prothrombin time (PT)
(N=10-13 secs)
therapeutic range: 1.5-2.0x normal value

45
Q

antidote for heparin?

A

protamine sulfate

46
Q

antidote for warfarin?

47
Q

medications contraindicated in pt with increased ICP?

A

opiates and sedatives
depressants > cushing’s triad > respi and cardiac depression

48
Q

generalized type of seizure (head to toe)

49
Q

period DURING a seizure where there are mild to severe contractions?

A

tonic clonic

50
Q

position during a seizure (tonic clonic)?

A

flat/ supine

51
Q

period AFTER a seizure/ exhaustion phase

A

post ictal

52
Q

position after a seizure?

A

side-lying

53
Q

type of seizure with a blank facial expression, automatism, and lip smacking?

A

petite mal/ absent/ blank seizure

54
Q

type of seizure which starts with tonic clinic and progresses into a grand mal seizure

A

jacksonian seizure

55
Q

type of seizure common in adults; mental clouding and intoxication

A

psychomotor seizure

56
Q

type of seizure most common in pedia; aka under 5 seizure

A

febrile seizure
progressive increase in temp > may cause convulsions

57
Q

most dangerous type of seizure; up to 30 mins of on and off/ continuous seizure

A

status epilepticus

58
Q

seizure medication hydantoins: phenytoin causes what side effects? (2)

A

gingival hyperplasia (HE: soft bristle toothbrush, meticulous oral care)
pinkish red urine (HE: inform S/O)

59
Q

medication used to decrease seizure episodes?

A

benzodiazepines/ anxiolytics

60
Q

seizure medication used for refractory seizure and prevents reoccurrence?

A

iminostilbenes (carbemapizine)

61
Q

seizure medication given ONLY AS A LAST RESORT due to S/E hepatotoxicity

A

valproates/ valproic acid

never given in pregnancy! can cause neural tube defects

62
Q

surgical removal/ resection of cranial nerve involved in seizure activity?

A

neurectomy

63
Q

diagnostic test used to detect bacterial meningitis?

A

lumbar puncture for CSF analysis

64
Q

disease caused by infection of the meninges

A

bacterial meningitis

65
Q

position of the pt. during lumbar puncture?

A

C-shape/ fetal/ genupectoral/ knee-chest position

66
Q

causative agent of bacterial meningitis?

A

neisseria meningitides

67
Q

CSF analysis result of pt with bacterial meningitis?

A

cloudy in color (increased WBC and protein content)
protein is a byproduct of bacteria

68
Q

management of bacterial meningitis?

A

antibiotic therapy

69
Q

S/S of bacterial meningitis:
pain in the hamstring, back, and neck when flexed?

A

+ Kernig’s sign
think (K)nee = Kernig

70
Q

S/S of bacterial meningitis:
pain in the back, and neck when flexed?

A

+ Brudzinski sign
think (B)atok = Brudzinski

71
Q

S/S of bacterial meningitis:
stiffness in the neck?

A

nuchal rigidity (move body and head as one unit)

72
Q

S/S of bacterial meningitis:
arching of the back

A

opisthotonus

73
Q

how do you position an opisthotonus pt.?

A

side-lying

74
Q

head trauma where there is jarring of the brain causing loss of consciousness?

A

concussion

75
Q

head trauma where there is extravasation of blood/ bruising causing structural alteration?

76
Q

in the PH, infant car seats for children < 3y/o should be ___

A

rear-facing (protect the spine)

77
Q

in the PH, infant car seats for children > 3y/o should be ___

A

front/ forward-facing

78
Q

most important prognostic indicator in children after a head trauma?

A

loss of consciousness

79
Q

immediate nsg action for a pt. with a cervical neck injury?

A

immobilize (to prevent further damage)

80
Q

sng action for a pt. with no cervical neck injury?

A

HOB elevated to decrease ICP with gravity
low fowler’s (30 degrees)

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