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Nursing 353 > Pediatric Neurological & Mobility Deficits > Flashcards

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
Q

How are chronically ill children transitioned into adult life?

A

individualized plan, adult oriented health care, alternate living arrangements, work skills.

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26
Q

What is cerebral palsy

A

non-progressive motor and posture dysfunction/

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27
Q

What causes cerebral palsy?

A

secondary to injuries to CNS insults like hypoxia, congenital, or traumatic origin.

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28
Q

When can cerebral palsy be caused?

A

prenatal, perinatal, or post natal up to 2 years.

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29
Q

What is the most common chronic DISORDER of childhood?

A

cerebral palsy

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30
Q

What is the most common type of CP?

A

Spastic.

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31
Q

What is spastic CP?

A

Most common, can involve one or both sides of body. Peristent hypERtonia, rigidity is classic hallmarl. Exaggerated DTR’s, persistent PRIMITIVE reflexes.

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32
Q

What would commonly be found in someone with spastic CP?

A

Contractures and abnormal spinal curvatures.

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33
Q

What is the Dyskinetic Type of CP?

A

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
Q

What is ataxic CP?

A

Lack or balance and position sense. Hypotonia in infancy, muscular instability, gait disturbances.

35
Q

What is mixed type CP?

A

unique compensatory movements and posture to maintain control over a specific area or neuromotor defects. combination of other types of CP.

36
Q

What is the most common manifestation in all types of CP?

A

delayed gross motor development.

37
Q

What are some manifestations of CP?

A

Failure to achieve milestones, abnormal muscle performance, abnormal posturing esp scissoring legs, reflex abnormalities, mental retardation, seizures, ADHD, sensory impairment.

38
Q

When should parents be concerned about CP?

A

Any infant with poor suck should be evaluated.

39
Q

What should the focus be in in CP?

A

Reaching maximum potential.

40
Q

Who should someone with CP be reffered to?

A

OT, PT, speech, special ed, ortho, hearing, and vision.

41
Q

Nursing management CP

A

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
Q

What is Duchenne Muscular Dystrophy?

A

PROGRESSIVE group of disorders that cause progressice weakness of skeletal muscle.

43
Q

What is the most common type of MD?

44
Q

What is the most severe type of MD? ?

45
Q

What does MD lead to?

A

Death by adolescence, from infection or cardiopulmonary failure.

46
Q

What may cause MD?

A

1/2 of cases are X linked.

47
Q

What is MD?

A

A lack of dystrophin, a protein in skeletal muscle fibers, which results gradual degeneration of muscle fibers.

48
Q

Assessments and Initial S&S of MD

A

weakness in pelvic girdle
delays in motor development
difficulties in running, biking, and stairs

49
Q

what are some progressive S&S of MD

A 
apparent abnormal gait
walking ceases by 9-12
gower's sign
pseudohypertrophy of calf muscles 
cardiac problems
delayed or impaired development.
50
Q

MD diagnostics

A

DNA from peripheral blood, muscular biopsy, ECG, EMG

51
Q

Nursing management of MD

A

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
Q

What is Hydrocephalus

A

structural disorder in production or absorption of CSF

53
Q

What are the clinical manifestations of hydrocephalus in older children?

A

Headache, no head enlargement, morning vomiting, confusion, apathy, ataxia, visual deficits. Signs of ICP

54
Q

What is the treatment for Hydrocephalus

A

Ventriculoperitoneal shunt.

55
Q

What are the concerns with a VP shunt

A

it can be come blocked, kinked, or infected.

56
Q

what is the most serious concern with a VP shunt?

57
Q

When does a neural tube defect form

A

in the 3-4th week of pregnancy

58
Q

what are the three types of neural tube defects?

A

Anencephaly
encephalpcele
spina bifida

59
Q

What is spina bifida occulta ?

A

doesn’t affect spinal cord, may have external dimpling of the skin, nevi, or hair tufts over dermal sinus.

60
Q

what is the treatment for spina bifida occulta ?

A

there is usually no treatment

61
Q

What is spina bifida meningocele?

A

a sac containing CSF and the meninges protruding out from the vertebrae.

62
Q

What is treatment for spina bifida meningocele?

A

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
Q

What is spina bifida myleomeningogele?

A

Similar to meningocele but also contains spinal cord and nerve roots.

64
Q

What is the sequale for myleomeningocele?

A

sensorimotor defects, urinary and bowel problems, possible in utero deformities.

65
Q

What is treatment for myelomeningocele?

A

multi disciplinary approach, no cure, cloure performed within 2-3 days to minimize infection and prevent further damage. shunting if hydrochephalus is present.

66
Q

What is Craniosynostosis?

A

premature closure of cranial sutures.

67
Q

What is treatment for craniosynostosis?

A

reconstructive surgery before 1 year of age.

68
Q

What is lead poisoning?

A

a blood serum of 10mcg/dl is considered positive.

69
Q

How does lead affect the body

A

nervous system and irreversible brain damage, displaces iron on heme, excreted through kidneys, adverse affects on vitamin D and calcium metabolism.

70
Q

What are the clinical manifestations for lead poisoning?

A

decreased IQ scores, cognitive deficits, loss of hearing, growth delays.

71
Q

Signs of acute lead poisoning

A

Nasuea and vomiting, anorexia, constipation, abdominal pain.

72
Q

Signs of low dose poisoning?

A

behavioral changes that look like adhd

73
Q

What are signs of high dose lead poisoning?

A

encephalopathy, seizures, mental retardation, paralysis, blindmess, coma, death.

74
Q

What is the treatment for lead poisoning?

A

chelation tx if level is over 45 mcg.dl

75
Q

What is near drowning

A

child who had treatment for drowning and survives for at least 24 hours after submersion in liquid

76
Q

Drowning is what cause of death in children?

A

it is the second leading accidental cause of death in children.

77
Q

When is a good prognosis indicated in a near drowning event?

A

submersion in under 5 minutes, with less than 10 minutes of CPR

78
Q

Where do most infants drown

79
Q

Where do children ages 1-4 drown

A

artificial pools

80
Q

where do the adolescence drown

A

fresh bodies of water

81
Q

Why do very young children fare better when submerged in water less than 70 degrees?

A

mammalian response, they shunt blood from periphery to vital organs.

Nursing 353 (13 decks)

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