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Pediatric Neurological & Mobility Deficits Flashcards

1
Q

At what age to sutures fuse on the head

A

18 months

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2
Q

When do your nerves finish mylenating

A

4-5 years

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3
Q

Differences in pediatric brain

A

Brain in child is highly vascular with less CSF, less cushion making them more prone to trauma.

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4
Q

When are pediatric seizures most common

A

infancy 1 in 1,000, and in children 2-4 percent.

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5
Q

Do seizures in children decrease in age?

A

yes

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6
Q

Types of pediatric seizures

A

focal or generalized

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7
Q

What can cause febrile temperatures

A

rapid change in temp from hot to cold or cold to hot.

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8
Q

Who is at greatest risk for bacterial meningitis

A

Infants, 70% < 5 yrs old.

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9
Q

What can cause meningitis in infants

A

otitis media, sinusitis, pneumonia, brain trauma, nerosurgical procedure.

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10
Q

3 types of bacteria that cause bacterial meningitis in infants.

A

HIB, Strept pneumoniae, Neisseria meningitis.

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11
Q

what has caused a decline in meningitis

A

use of HIB and pneumoccal vaccines.

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12
Q

Meningitis manifestations in Infant

A

Fever, change in feeding, flat or bulging fontanel, restlessness, lethargy, or irritability, hard to console.

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13
Q

Meningitis manifestations in children?

A

fever, irritability, lethargic, combative, confused, photophobia, nuchal rigidity, HEADACHE. possibly rash, petechiae, purpura

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14
Q

What type of meningitis has increased in young adult?

A

Meningococcal meningitis

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15
Q

Therapy for meningitis

A

History, PE, labs, lumbar puncture, administer antibiotics based on lab results.

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16
Q

meningitis sequale

A

neurologic damage, seizures, hearing loss, developmental delays, multisystem organ death.

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17
Q

Viral (aseptic) meningitis presentation S&S

A

inflammatory process, increase WBS and protein in CSF, culture will NOT grow bacteria, patient won’t appear ill, still treat aggresively for 48 hours.

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18
Q

What is Reye syndrome

A

Acute encephalopathy caused by toxin, injury, inflammation, or anoxic insult. unclear etiology, associated with viral illnesses and asprin.

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19
Q

What is the best way to prevent Reye syndrome?”

A

Teach parents about aspirin

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20
Q

What is Guillan Barre syndrome?

A

Post infectious polyneuritis, caused by an auto-immune response to infectious organism 2-3 weeks prior.

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21
Q

What are symptoms of Giillan Barre?

A

Deteriorating motor function and paralysis in ascending pattern from lower extremities upward.

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22
Q

What is the treatment for guillan barre?

A

immunoglobin

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23
Q

Is guillan barre fata?

A

rarely, respiration difficulty may require ventilation.

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24
Q

What are some special needs of children with disabilities?

A

Growth and development, body image/self esteem, autonomy, socialization, schooling, communication, family needs and interactions with siblings, financial needs.

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25
How are chronically ill children transitioned into adult life?
individualized plan, adult oriented health care, alternate living arrangements, work skills.
26
What is cerebral palsy
non-progressive motor and posture dysfunction/
27
What causes cerebral palsy?
secondary to injuries to CNS insults like hypoxia, congenital, or traumatic origin.
28
When can cerebral palsy be caused?
prenatal, perinatal, or post natal up to 2 years.
29
What is the most common chronic DISORDER of childhood?
cerebral palsy
30
What is the most common type of CP?
Spastic.
31
What is spastic CP?
Most common, can involve one or both sides of body. Peristent hypERtonia, rigidity is classic hallmarl. Exaggerated DTR's, persistent PRIMITIVE reflexes.
32
What would commonly be found in someone with spastic CP?
Contractures and abnormal spinal curvatures.
33
What is the Dyskinetic Type of CP?
Abnormal involuntary movements that disappear in sleep and increase with stress. impaired voluntary muscle control. bizarre twisting movements, tremors, exaggerated posturing, inconsistent muscle tone.
34
What is ataxic CP?
Lack or balance and position sense. Hypotonia in infancy, muscular instability, gait disturbances.
35
What is mixed type CP?
unique compensatory movements and posture to maintain control over a specific area or neuromotor defects. combination of other types of CP.
36
What is the most common manifestation in all types of CP?
delayed gross motor development.
37
What are some manifestations of CP?
Failure to achieve milestones, abnormal muscle performance, abnormal posturing esp scissoring legs, reflex abnormalities, mental retardation, seizures, ADHD, sensory impairment.
38
When should parents be concerned about CP?
Any infant with poor suck should be evaluated.
39
What should the focus be in in CP?
Reaching maximum potential.
40
Who should someone with CP be reffered to?
OT, PT, speech, special ed, ortho, hearing, and vision.
41
Nursing management CP
Prevention of injury, prevent physical deformity, promote mobility, ensure adequate nutrition, foster relaxation and general health, administer meds, encourage self care and independence when possible.
42
What is Duchenne Muscular Dystrophy?
PROGRESSIVE group of disorders that cause progressice weakness of skeletal muscle.
43
What is the most common type of MD?
Duchenne
44
What is the most severe type of MD? ?
Duchenne
45
What does MD lead to?
Death by adolescence, from infection or cardiopulmonary failure.
46
What may cause MD?
1/2 of cases are X linked.
47
What is MD?
A lack of dystrophin, a protein in skeletal muscle fibers, which results gradual degeneration of muscle fibers.
48
Assessments and Initial S&S of MD
weakness in pelvic girdle delays in motor development difficulties in running, biking, and stairs
49
what are some progressive S&S of MD
``` apparent abnormal gait walking ceases by 9-12 gower's sign pseudohypertrophy of calf muscles cardiac problems delayed or impaired development. ```
50
MD diagnostics
DNA from peripheral blood, muscular biopsy, ECG, EMG
51
Nursing management of MD
assess for disorder progression, maintain optimal mobility, compensate for disuse syndrome, support family and child with coping, refer, teach, assist in finding genetic counseling.
52
What is Hydrocephalus
structural disorder in production or absorption of CSF
53
What are the clinical manifestations of hydrocephalus in older children?
Headache, no head enlargement, morning vomiting, confusion, apathy, ataxia, visual deficits. Signs of ICP
54
What is the treatment for Hydrocephalus
Ventriculoperitoneal shunt.
55
What are the concerns with a VP shunt
it can be come blocked, kinked, or infected.
56
what is the most serious concern with a VP shunt?
infection
57
When does a neural tube defect form
in the 3-4th week of pregnancy
58
what are the three types of neural tube defects?
Anencephaly encephalpcele spina bifida
59
What is spina bifida occulta ?
doesn't affect spinal cord, may have external dimpling of the skin, nevi, or hair tufts over dermal sinus.
60
what is the treatment for spina bifida occulta ?
there is usually no treatment
61
What is spina bifida meningocele?
a sac containing CSF and the meninges protruding out from the vertebrae.
62
What is treatment for spina bifida meningocele?
to close the site as soon as possible, apply sterile saline soaked dressing, do not place diaper over location of site. position infant in prone or side lying position.
63
What is spina bifida myleomeningogele?
Similar to meningocele but also contains spinal cord and nerve roots.
64
What is the sequale for myleomeningocele?
sensorimotor defects, urinary and bowel problems, possible in utero deformities.
65
What is treatment for myelomeningocele?
multi disciplinary approach, no cure, cloure performed within 2-3 days to minimize infection and prevent further damage. shunting if hydrochephalus is present.
66
What is Craniosynostosis?
premature closure of cranial sutures.
67
What is treatment for craniosynostosis?
reconstructive surgery before 1 year of age.
68
What is lead poisoning?
a blood serum of 10mcg/dl is considered positive.
69
How does lead affect the body
nervous system and irreversible brain damage, displaces iron on heme, excreted through kidneys, adverse affects on vitamin D and calcium metabolism.
70
What are the clinical manifestations for lead poisoning?
decreased IQ scores, cognitive deficits, loss of hearing, growth delays.
71
Signs of acute lead poisoning
Nasuea and vomiting, anorexia, constipation, abdominal pain.
72
Signs of low dose poisoning?
behavioral changes that look like adhd
73
What are signs of high dose lead poisoning?
encephalopathy, seizures, mental retardation, paralysis, blindmess, coma, death.
74
What is the treatment for lead poisoning?
chelation tx if level is over 45 mcg.dl
75
What is near drowning
child who had treatment for drowning and survives for at least 24 hours after submersion in liquid
76
Drowning is what cause of death in children?
it is the second leading accidental cause of death in children.
77
When is a good prognosis indicated in a near drowning event?
submersion in under 5 minutes, with less than 10 minutes of CPR
78
Where do most infants drown
bathtubs
79
Where do children ages 1-4 drown
artificial pools
80
where do the adolescence drown
fresh bodies of water
81
Why do very young children fare better when submerged in water less than 70 degrees?
mammalian response, they shunt blood from periphery to vital organs.

Nursing 353 (13 decks)

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