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Pathopharm > peds neuro cont (1) > Flashcards

peds neuro cont (1) Flashcards

1
Q

abnormal “normal” labs for Hypothyroidism is:

A

low T4, high TSH

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2
Q

Symptoms of hypothyroidism in newborn include:

A

too good baby= quiet & good baby, prolonged jaundice, lethargy, poor appetite, bradymacroglossia (large tongue), long gestation > 42 weeks

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3
Q

What happens if levothyroxine sodium is not given to patient shortly after birth?

A

mental retardation and growth failure

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4
Q

Inadequate treatment ( med underdose) for congenital hypothyroidism can lead to

A

fatigue, sleepy, decrease appetite, constipation

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5
Q

Levothyroxine overdose includes

A

rapid pulse, irritability, fever, weight loss, and diarrhea

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6
Q

What should you educate parents about in regards to congenital hypothyroidism tx with levothyroxine?

A

check pulse before tx, single dose in AM, and child will need lifelong tx

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7
Q

_____ is defined as abnormal electrical activities in the nerve cells in the brain

A

seizures

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8
Q

Convulsion

A

a more severe seizure characterized by involuntary spasmodic contraction of any or all muscles throughout the body

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9
Q

Epilepsy

A

a chronic recurrent pattern of seizure activities

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10
Q

How long can a status epilepticus seizure last

A

Tonic-clonic seizures up to 30 min

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11
Q

Status epilepticus involves ____ involvement, ______, ___tension, PVCs

A

status epilepticus involves airway involvement, hypoxia, hypotension, and PVCs

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12
Q

Biggest differences between generalized and partial seizure

A

Generalized = affect the entire brain surface consciousness loss. Partial = affects part of the brain surface

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13
Q

What is the tonic and clonic?

A

tonic phase- generalized stiffness of entire body. Clonic phase- spasm followed by relaxation

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14
Q

The 3 types of generalized seizures include:

A

tonic clonic (grand mal), absence (petit mal), myoclonic

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15
Q

Biggest difference between tonic-clonic (grand mal) and absence (petit mal)

A

TC= loss of consciousness. A= momentary loss

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16
Q

Absence (petit mal)

A

momentary loss of consciousness, posture maintained, minor face, eye and hand movement

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17
Q

Difference between simple and complex partial seizure

A

simple= no impairment of consciousness. Complex= impaired consciousness

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18
Q

Patient has an aura, Loss of consciousness, stiffness, apnea, cyanosis, pupil dilated, incontinence is a description of ______

A

tonic-clonic (grand mal)

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19
Q

This seizure lasts 5 - 10 seconds, appears inattentive, daydreaming, age 4-12 year old is an example of what type of seizure

A

absence seizures ( petit mal)

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20
Q

What happens in post-ictal phase?

A

CNS depression, patient may be disoriented and sleepy

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21
Q

What is the most common cause of increased seizure activity?

A

non compliance with medication

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22
Q

Tegretol, dilantin, and depakene are used to tx what?

A

partial simple or complex seizures

23
Q

Zarontin and Depakene are used to treat what?

A

absence seizures ( petit mal)

24
Q

Tx for status epilepticus includes

A

valium and ativan

25
Q

Diazepam (Valium)

A

short acting and must be given in repeated doses. Usually followed by long acting anticonvulsant ( Dilantin)

26
Q

Lorazepam (Ativan)

A

drug of choice for status epilepticus because it lasts longer than Valium

27
Q

_____ _____ is seizure not controlled by meds

A

intractable epilepsy

28
Q

If meds don?t work for epilepsy, what are alternatives?

A

Ketogenic diet, surgery, vagus nerve stimulator, experimental drugs

29
Q

Ketogenic diet

A

high-fat, adequate protein, low-carb diet

30
Q

What should the nurse educate parents about epilepsy home management?

A

drug monitoring, med withdrawal, counseling, safety, immunizations

31
Q

You witness a seizure, what do you do?

A

assess immediate environment & protect pt. from harm, assess airway, O2 prn, medicate, side laying afterward, observe and describe (time, incontinence)

32
Q

This disease is an acquired neuromuscular disorder with a bacterial, viral or congenital origin leading to inflammation and demyelination of the myelin sheath causing impaired nerve conduction

A

Guillain-Barre Syndrome

33
Q

Paresthesia

A

numbness and tingling

34
Q

What would you find a nursing assessment of a patient with Guillain Barre?

A

paresthesia, muscle weakness of less (progressing to face, trunk and upper extremities), difficulty in talking, chewing, swallowing, increase HR, pain in back of leg, ortho HTN

35
Q

What is supportive nursing care for guillan barre patients?

A

monitor respiratory status, positioning and skin care, ROM and PT, and urinary cath

36
Q

Common medication management for GBS include:

A

IV immunoglobulins (lessen the immune attack), steroids, and plasmapheresis (removes antibodies)

37
Q

What are the #1 cause for spinal cord injury in a newborn and an infant?

A

newborn- shaken baby. Older child- MVA

38
Q

True or false, you should use a rigid cervical collar on immobilization board for anyone with spinal cord injury

A

TRUE

39
Q

Would you take a child that was just in a car accident out of his or her carseat?

A

NO

40
Q

You are the nurse caring for Timmy who has sustained a severe spinal cord injury. You need to give him some medication to prevent any further swelling. You have prednisone and methylprenisolone available. Which do you give and how often?

A

Methylprednisolone, Q 8 hours

41
Q

Describe your assessment for Timmy ( spinal cord injury)

A

assess breathing pattern & auscultate lungs, check neurologic vital signs frequently (sensory and motor), cardio status, abdomen for distention, temp (hyperthermia common), psychosocial status

42
Q

You are discharging Timmy (spinal cord injury), what education would you provide to him and his family as to when they should seek medication attention?

A

recurrent vomiting, seizure, loss of consciousness, worsening headache, change in behavior, difficulty walking

43
Q

In what disease does organisms spread to CNS causing inflammatory response?

A

Meningitis

44
Q

Haemophilus influenza, neisseria meningitis, streptococcus pneumoniae are all causes of which type of meningitis?

A

Bacterial

45
Q

What might a lumbar puncture show in meningitis?

A

Increased WBC, decrease glucose, elevated protein, increase ICP, positive culture for meningitis

46
Q

Clinical Manifestations of an older child with meningitis include:

A

s/s of increased ICP (LOC changes, irritability, vomiting), neck stiffness, photophobia, Kernig sign, Brudzinski sign, fever, chills)

47
Q

Clinical Manifestations of an infant with meningitis include:

A

absence of classic signs, ill, poor feeding, vomiting, BULGING FONTANELS, seizures

48
Q

True or False, there is a vaccine for meningitis

A

TRUE

49
Q

Most brain tumors are _____, making them difficult to excise surgically. Also, are close to ___ structures

A

infratentorial, vital

50
Q

What are common symptoms associated with brain tumors?

A

headache upon wakening, vomiting with nausea, loss of concentration, change in behavior, vision problems

51
Q

Post-op care priorities for brain tumor excision include:

A

increased ICP and seizures, monitor I & O, admin steroids and osmotic diuretics

52
Q

In post-op phase of brain tumor surgery, how are you going to position your client?

A

Keep HOB elevated to decrease swelling. Most infratentorial tumors are prescribed to lie flat or turn to either side

53
Q

What 4 things can cause increased ICP?

A

suctioning, coughing, straining, and turning

Pathopharm (24 decks)

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