Pediatric - Neurology

Question 1

Cerebral Palsy

Answer 1

Condition resulting in impaired movement and posture due to an abnormality in the motor system. Most common type is spastic due to upper motor neuron weakness.

Question 2

Interventions for Cerebral Palsy

Answer 2

PT, OT, speech therapy, education and recreation. Use of mobilizing devices, safe environment, sitting upright after meals and medication.

Question 3

Signs and symptoms of head injury

Answer 3

EARLY SIGNS

1. Increased ICP
2. McEwan’s sign (cracked pot sound on percussion of head)
3. Headache
4. N&V
5. Diplopia and seizures

LATE SIGNS

1. Reduced consciousness level
2. Bradycardia
3. Lowered motor responses
4. Posturing

Question 4

Interventions for head injury

Answer 4

1. Monitor Airway
2. Monitor for signs of increased ICP
3. Decrease stimuli
4. Monitor ops and neuro ops
5. Seizure precautions

Question 5

Seizure precautions

Answer 5

1. NPO
2. IV fluids
3. Antiseizure medications

Question 6

Hydrocephalus

Answer 6

Imbalance of CSF absorption or production caused by malformations, tumors, hemorrhage, trauma or infection. Results in enlargement of head and increase ICP.

Question 7

Surgical Intervention for Hydropcephalus

Answer 7

Prevent further CSF accumulation by bypassing the blockage and draining it to where it will be reabsorbed.

Question 8

Meningitis

Answer 8

Infection process of the CNS caused by bacteria or viruses. Diagnosis via a lumbar puncture.

Question 9

What should the CSF from a lumbar puncture look like if it is positive for meningitis?

Answer 9

1. Cloudy CSF
2. Elevated protein
3. Decreased glucose

Question 10

Interventions for meningitis

Answer 10

1. Respiratory isolation for 24 hours after antibiotic administered.
2. Antibiotics
3. Antipyretics
4. Monitor neuro obs
5. Monitor for edema

Question 11

Interventions for submersion injury

Answer 11

1. Ventilatory and circulatory support
2. Monitor for cerebral edema
3. Monitor for aspiration pneumonia
4. Monitor neuro obs

Question 12

Reye’s Syndrome

Answer 12

Acute encephalopathy which follows a viral illness characterized by cerebral edema and fatty changes to the liver. Diagnosed via liver biopsy.

Use of aspirin in contraindicated in children due to its association with Reye’s syndrome.

Question 13

Signs and symptoms of Reye’s Syndrome

Answer 13

1. Viral illness prior to onset
2. Fever
3. N&V
4. Altered hepatic function
5. Progressive neurological deterioration
6. Increase in blood ammonia levels

Question 14

Interventions for Reye’s Syndrome

Answer 14

1. Rest and decreased stimulation
2. Assess near ops
3. Monitor hepatic function
4. Fluid balance
5. Monitor for impaired coagulation

Question 15

Tonic-clonic seizure

Answer 15

Stiffening of limbs, losing consciousness and falling to the floor with the eyes rolling back (tonic) followed by muscle spasms and jerking (clonic).

Question 16

Absence Seizures

Answer 16

Begins with no warning. People stare without moving, lasts less than 15 seconds and is followed by an instant return to alterness.

Question 17

Myoclonic Seizures

Answer 17

Brief, shock-like jerks of muscle. Person is awake and alert throughout.

Question 18

Atonic seizures

Answer 18

Causes muscles to go limp resulting in slumping or crumpling to the floor.

Question 19

Neural Tube Defects

Answer 19

A CNS defect where the neural tube (pre-spine) fails to close during embryonic development. Defect is normally surgically closed after birth.

Question 20

Spina bifida occulta

Answer 20

Type of neural tube defect in which the spinal cord arches but it still intact.

Question 21

Spina bifida cystica

Answer 21

Type of neural tube defect in which there is a saclike protrusion of the spinal cord outside the body.

Question 22

Meningocele

Answer 22

Type of neural tube defect in which there is a protrusion of the meninges in a saclike cyst outside the body.

Question 23

Mylomeningocele

Answer 23

Type of neural tube defect in which there is a protrusion of the meninges, CSF, nerve roots and spinal cord outside the body. Usually accompanied by neurological defects in the individual.

Question 24

Decorticate posturing indicates

Answer 24

A lesion in the cerebral hemisphere or disruption of the corticospinal tracts

Question 25

Decerebrate posturing indicates

Answer 25

Decerebrate posturing indicates damage in the diencephalon, midbrain, or pons.

Question 26

Decorticate Posturing

Answer 26

An abnormal flexion of the upper extremities and an extension of the lower extremities with possible plantar flexion of the feet.

Question 27

Decerebrate Posturing

Answer 27

An abnormal extension of the upper extremities with internal rotation of the upper arms and wrists and an extension of the lower extremities with some internal rotation.