Pediatric neurological Disorders NUR 2310 Flashcards
what is hydrocephalus
Imbalance in the production and absorption of cerebrospinal fluid (CSF) in the ventricular system
what should the nurse do in Hydrocephalus Monitoring
Head circumference (occipitofrontal circumference)
Fontanel tension
Serial ultrasound examinations of ventricle size
a parent went for their new born check up. the nurse measures the head at 40cm when it should be 33cm to 35cm, what condition does the nurse suspects
Hydrocephalus a condition that may be congenital or acquired when there is increased CSF production. it can cause ICP
the doctor told the parents that the child has Hydrocephalus, they ask how is it treated, what would the doctor say
ventriculoperitoneal shunt. a catherter placed in the ventricles of the brain and drain it in the peritoneum
the parent of the Hydrocephalus child is happy to know that there is a cure and will never need surgery again. How does the nurse correct the misunderstanding
the child will live a normal life but will need to come back for revision of the shunt as a result of the rapid growth of the child to extend the shunt.
the Hydrocephalus child got the shunt placed successfully. a month later, they went to the emergency room saying that the baby wont stop crying and her fontanel is bulged. upon assessment the nurse noticed the child eyes does not constrict when light is shun. what is happening to the child
the Increased Intracranial Pressure has increased. Irritability; poor feeding
High-pitched cry; infant is difficult to soothe
Fontanels are tense and bulging
Cranial sutures are separated
Eyes have the setting-sun sign
Scalp veins are distended
Macewen sign
Increased occipitofrontal circumference
a 4yr old also came into the emergency room with his parent. the parent reports the child was acting unusual in the passed 2 days, saying weird things. he also says his son head hurts and is tripping often in the passed 2 days. he thought his child was looking for new ways to gain attention but he started to vomit non stop today. what is happening to the child.
Increased Intracranial Pressure has increased. Headache
Vomiting, with or without nausea
Motor weakness, discoordination, and seizures
Diplopia and blurred vision
Irritability, restlessness, and behavioral changes
Sleep alterations and somnolence
Personality changes
the nurse does a Glasgow Coma Scale on the child. eyes=3, motor response= 3, and response to verbal stimuli=4. what does this score indicate
he has amoderate head injury. Mild head injuries are generally defined as those associated with a GCS score of 13-15, and moderate head injuries are those associated with a GCS score of 9-12. A GCS score of 8 or less defines a severe head injury
Diagnostic procedures for head injuries
Laboratory tests: Glucose levels, complete blood count (CBC), electrolyte levels, blood culture if fever is present, evaluation for toxic substances, liver function tests
Imaging with CT scanning, magnetic resonance imaging (MRI), echoencephalography, ultrasound, nuclear brain scanning, positron emission tomography (PET)
Lumbar puncture
Electroencephalogram (EEG)
X-ray to rule out skull fractures or dislocations and evaluate degenerative changes and suture lines
A nurse observes a tuft of hair on the infant’s lower back. what does the nurse suspect
spina occulta. Usually lumbosacral, at L5 to S1
Skin indicators (absent, singly or combination)
Sacral dimple
Sacral angioma or port wine nevus
Sacral tufts of dark hair
Sacral lipoma. most times benign and does not have neurological defects
spina occulta when child grows older
Tethered cord
Abnormal adhesion to a bony or fixed structure
Puts traction on the cord
Altered gait
Bowel and bladder problems
Foot deformities
May not be seen in early infancy
Diagnostic Tests for Spina Bifida Occulta
X-ray
MRI
CT
Ultrasonography
Spina Bifida Meningocele
Sac contains meninges and spinal fluid but no neural elements
No neurologic deficits
Myelomeningocele
Neural tube fails to close
May be anywhere along the spinal column
Lumbar and lumbosacral areas are the most common
May be diagnosed prenatally or at birth. Sac contains meninges, spinal fluid, and nerves
Saline-soaked nonadhesive gauze or antibiotic-soaked gauze is used to keep the sac moist.
Varying and serious degrees of neurologic deficit
Clinically, the term myelomeningocele is interchangeable with the term spina bifida
the 17 yr old complains of constant headaches, stiff neck and seems irritable. his eyes are constantly squinting. he said he was fine yesterday afternoon but feels like he has a fever today. what SS does thus corolate with
a. influenza
b. ICP
c. meningitis
d. meningocyle
meningitis
Symptoms
Sudden onset, Preceding respiratory illness or sore throat, Fever and chills, Headache, Photophobia, Siff neck, Rash, Irritability, Drowsiness, Lethargy
Muscle rigidity, Seizure
