Quiz 3 Flashcards
NEUROLOGICAL STATUS:
Hx of history of headaches, blurred vision, changes in behavior, balance, coordination, motor function, fatigue, numbness/tingling, seizures, tremors, slurred speech, muscle strength, weakness, recent injury
Immunizations:
Dtap:
2mo, 4mo, 6mo, 18mo, Syrs +Boosters
Immunizations: Teens:
Tada! I’m a teen! Tdap Meningitis HPV
Increased Intracranial Pressured
nurse assesses a child with a CNS infection and notices a fontanel Bulging infection and high pitched cry
ared flag for ICP (Report cry to MD). Headaches in the middle of night an
Vomiting bc of it
ED if fever
Baby 3mo or younger go to
Following a head injury, an infant’s level of consciousness can deteriorate, s/s
increased or excessive sleeping, and eventually go into a coma. A Nurse monitoring this child should report excessive sleeping and raise a red flag for ICP after a trauma
Assess pupillary reaction to light. An increase in intracranial pressure due to acute hemorrhage can cause
neurological changes in pupillary reaction to light. Pupil responses to light can be unresponsive, unequal, or slow. NPO. Measure infants, head palpate fontanelles.
Older child: ICP
Headache Vomiting, with or without nausea Motor weakness, discoordination, and seizures Diplopia and blurred vision Irritability, restlessness, and behavioral changes Sleep alterations and somnolence Personality changes LATE SIGNS OF INCREASED ICP
Bradycardia
PAIN MANAGEMENT FOR THE COMATOSE CHILD PARALYTICS-
NORCURON- PAVULON
SEDATION - FENTANYL DRIP/Versed
What is a clinical manifestation of increased intracranial pressure (ICP) in infants?
a. Irritability
NURSING CARE OF UNRESPONSIVE CHILD.
initiate IV access
Important nursing observation in a child with a skull fracture is:
To monitor the child for signs of hemorrhage or edema.
SUBMERSION:
Near drowning: Risk for Aspiration Amount of time in the water and quality of resuscitation efforts will determine a child’s prognosis,
ENCEPHALITIS
inflammation of brain tissue, headache, decreased LOC, seizures, behavior changes, nausea, vomiting, changes in speech, increased ICP Organisms - viral, herpes, CMV. mosquitos, ticks, autoimmune Incubation 3-5 days Medication - Acyclovir 10 days
ENCEPHALITIS s/s
Headache
• Headache |
* Fever
* NV
* Nuchal rigidity
BACTERIAL MENINGITIS
Intracranial infection of meninges, headache, high fever, neck rigidity, inflammation causing edema, photosensitivity, nausea, vomiting, malaise, irritability Organisms bacterial, droplet transmission streptococcal, Neisseria, haemophiles pneumococcus, Incubation few hours to days Medication - Ampicillin & Cephalosporins
Vaccines THE ROUTINE USE OF H INFLUENZA TYPE B (Hib) AND STREP PNEUMONAIE (PCV13) VACCINES HAS REDUCED THE INCIDENCE OF BACTERIAL MENENGITIS Droplet precautions
BACTERIAL MENINGITIS s/s
Irritable
Headache
Fever
NV
CSF: elevated WBC count, neutrophils, protein and pressure, and decreased glucose.
Nuchal rigidity
Photophobia/Increased sensitivity to light
ASEPTIC MENIGITIS Patho:
Viruses that inflame meninges Measles, mumps, leukemia, herpes S/S: Fine skin rash
The nurse is assigned to child diagnosed with bacterial meningitis, which of the following would be appropriate: Respiratory isolation will remain for 24 hours.
REYE SYNDROME:
Acute encephalitis with altered LOC • ASA known to damage mitochondria of cell so intensifies viral process with endotoxins • Do not give Aspirin to child under 18
EPILEPSY:
Patient safety, lie lateral and if vomiting turn on side. Nursing management: Position the child laterally. Positioning the child laterally facilitates airway patency. Prevent risk of aspiration
STATUS EPILEPTICUS
Fosphenytoin with Phenobarb if phenytoin level is below therapeutic level. This puts the child at risk for seizure
- The nurse should suspect brainstem damage in child who presents with which of the following? Bilateral dilated, nonreactive pupils
CEREBRAL PALSY
Diagnosed one to two years after birth, stiff or rigid limbs, arching back, pushing away, floppy tone poor head control after three months unable to sit at eight months clenched fists after three months
POC; modify environment
CEREBRAL PALSY
A 6-month-old infant does not smile, has weak head control and a persistent Moro reflex, and often gags or chokes while eating. The nurse recognizes that these findings most likely suggest. By 8months they need to sit w/pillows propped: These symptoms are classic findings in children with cerebral palsy (CP).|
SPINAL MUSCULAR ATROPHY
Usually appears after two years
Werdnig-Hoffman Disease Autosomal Recessive Trait Paralytic disease
progressively worsens.
DUCHENNE MUSCULAR DYSTROPHY
Abchild with DMD will attain standing position by waddling gait & “Walking” up legs from a kneeling position (Gower sign) Note marked lordosis Maintain activity, mobility, independence. calf hypertrophy Genetic counseling, 60% family history Support family.
DUCHENNE MUSCULAR DYSTROPHY
Av child with DMD will attain standing position by waddling gait & “Walking” up legs from a kneeling position (Gower sign) Note marked lordosis Maintain activity, mobility, independence. calf hypertrophy Genetic counseling, 60% family history Support family.
DUCHENNE MUSCULAR DYSTROPHY
Av child with DMD will attain standing position by waddling gait & “Walking” up legs from a kneeling position (Gower sign) Note marked lordosis Maintain activity, mobility, independence. calf hypertrophy Genetic counseling, 60% family history Support family.
SCABIES (BED BUGS):
Caused by scabies mite as female burrows into the epidermis to deposit eggs and feces (rash w/burrows).
INFANT BOTULISM
Food poisoning from spores anaerobic Bacilli Clostridium Botulinum
Improperly sterilized home canned foods
Honey and dark corn syrup formulas
* Signs and symptoms - constipation, weakness, lack of head control dizziness, headache, diplopia, speed difficulties, vomiting, progresses to resp paralysis : San ecouis has feeding dificulties and hypotonia but poor refoxes.
PEDICULOSIS CAPITIS (HEAD LICE):
white particles on the hair. Pediculus capitis, or head lice, are tiny parasitic insects that live on the scalp and can be spread by close contact with other people. Their eggs (nits) appear much like flakes of dandruff but stick firmly to the hair shaft instead of flaking off of the scalp.
PEDICULOSIS CAPITIS (HEAD LICE): teaching
“All recently used clothing, bedding, and towels must be washed in hot water.” Anything that cannot be washed should be sealed in a plastic bag for 10 to 14 days. Non-washable items can include jackets, sweaters, hats, pillows, bicycle helmets, and stuffed animals. Furniture, carpets, and car seats can be sprayed with a variety of over-the-counter products.
IMPETIGO
is a highly contagious bacterial skin infection with honey crusted lesions •Also teach the parent to ensure the child changes her clothes every day and to wash all clothing in hot water. •Have the infected child use their own utensils and towels • Tx: Antibiotics
IMPETIGO; nursing consideration
The nurse should keep and use dedicated equipment, such as blood pressure monitor, stethoscope, and thermometer in the client’s room to prevent the spread of infection from client to client.
INTESTINAL PARASITES. S/s
Helminths (worms): Pinworms • Protozoa: Giardiasis S/S Perianal Itching Abd pain, nausea, diarrhea, bloating, “wiggling their seat”.
INTESTINAL PARASITES. S/s
Helminths (worms): Pinworms • Protozoa: Giardiasis S/S Perianal Itching Abd pain, nausea, diarrhea, bloating, “wiggling their seat”.
INTESTINAL PARASITES: assessment
The child would undress and put on an examination gown or undergarments. Anticipate that the provider would do a genital examination due to the complaint and explain the procedure to the parent and child.
INTESTINAL PARASITES: Test
Clear tape (not tape with a frosted finish or “magic tape”) is used in a loop with the sticky side out and pressed firmly against the child’s perianal area at night during sleep.
* Stool samples are collected in the morning as soon as the child awakens and BEFORE the child has a bowel movement or bathes.
: The samp fe broug the fre die a toret a pisivaminion by placing the tape
smoothly on a glass slide, with the sticky side down.
• Parents are instructed to carefully clean their hands before and after collecting
* Specimens must be kept in a glass jar or sealed bag.
AUTISM SPECTRUM DISORDERS (ASDS)
Complex neurodevelopmental disorders of brain function (Range from mild to severe)
Impaired social interaction, don’t play well with others, avoid eye contact, lack of empathy, tantrums.
Restice riperve and storeotyped patterns of behavior, interests, and activities
(Lining up cars)
* Delays or abnormal functioning with onset before 3 years of age (MCHAT screening at
WCC) Tx: Structured routines, reward system for positive behavior, always supervise activities, SSRis, Antipsychotics, melatonin, family support.
