Peds Exam 3b - NeuroMus Flashcards
cerebral palsy
a problem with the brain so the brain cannot control the muscle groups as it should
either from connectoris which is when you become very jaundice and it crosses the blood brain barrier, premature birth, stroke, or shaken baby
is CP progressive?
no, it is just more manageable as a infant / child
how is CP classified
by type and severity
spastic CP
upper motor neuron muscular weakness, persistent primitive reflex, hypertonicity
the child has a lot of contractures, drooling and is much more severe
when is CP dx vs a stroke
if a child is under 2yr old, we will dx as CP but we do not confirm until after 2yrs -> will say they are delayed or need extra help
how do we dx CP
-missed milestones
-persistent primitive reflexes
-abnormal muscle tone/ floppy/ grimacing
-not using both side of body equally
-early hand preference
-poor suck & tongue thrust
-uncoordinated movements
symptom based, no test
when should an infant sit up without assists
8mo -> send to pt
when does an infant develop a dominant hand
early would be 12-15mo
reflexes:
rooting
moro(startle)
tonic
grasping
babinski
-4M
-4M
-6M
-6M
-2yr
when should a child smile by
2 months
what back alignment is commonly seen in spastic CP
opisthotonic posture: curved, C shaped spine
scissoring
when the knees buckle together/cross over each other, commonly seen in spastic CP
clinical manifestations of CP
-mental impairment
-seizures
-contractures
-incontinence
-ADHD
-non ambulatory spastic
-feeding difficulties FTT
-res, vision, oral & hearing problems
what complications does non ambulation cause
-constipation
-orthopedic problems
-skin breakdown
-respiratory infections
therapeutic mgt of CP
all symptom based w/ goal to promote as much independence as possible
-botox to relax muscle
-surgery for contractures
-OT + PT + ROM exercises
-braces & walkers
medical mgt of CP
-seizure meds if needed
-anxiety meds if needed
-baclofen to help with spasms
-bowel regimen (enemas, schedule, suppository) training
CP home care
-support family
-get them into schools & educate on inclusion at school
-use of assistive devices & exercise
-proper med admin
-prevent skin breakdown
-nutrition & play
-safety needs
CP nursing care
-assessment & early ID to get into treatment
-reinforce therapeutic plan (positive & offer suggestions)
-help improve muscle tone & control
-make sure they are up to date on immunizations
best thing we can do is to get them into therapy
muscular dystrophy
a genetic disorder that effects dystrophin which is what keeps our muscles intact -> the mutation leads to the muscle falling apart