The Unconcious Child Flashcards
Emergency management of unconscious child:
Monitor Airway > increased ____ retention causes increased Respirations which increases _______ to the brain which then increases ICP. ON EXAM.
CO2
Blood flow
Emergency management of unconscious child:
Reduce the _____ > Prevent Crying/Pain/CO2 retention
ICP
Emergency management of unconscious child:
Monitor _______ > Assess for signs of increase or decrease. Ex. Cheyne Stokes.
respirations
Emergency management of unconscious child:
Monitor for signs and symptoms of _____ > Decreased BP, tachypnea, increased urination, vomiting, diarrhea, and changes in LOC. The RN should treat the shock.
shock
Emergency management of unconscious child:
Prevent _______ stimulation > This increases peristalsis which increases sensory input to the brain which increases ICP.
Ex. any suctioning or repositioning or movement of any kind is going to stimulate the abdominal area which stimulates the brain and increases intracranial pressure as well.
Abdominal
Pain management of the unconscious patient:
Assess for signs of pain > AEB Increased _____ or _____. Reduce pain quickly because pain increases ICP. ON EXAM.The RN should use really gentle ______ exercises to decrease rigidity.
agitation or rigidity
range of motion
Assess for alterations in vital signs: \_\_\_\_\_\_ in heart rate, Increased or decreased respirations Ex. Cheyne Stokes Respirations \_\_\_\_\_\_\_ in Blood Pressure \_\_\_\_\_\_\_ in O2 sats less than 70 to 100.
Increase
Increase
Decrease
Medications to administer an unconscious child:
What are the names of the two medications which are used to paralyze the child to decrease rigidity which increases metabolic rate and increases oxygen requirements.
Pancuronium Bromide / Pavulon
Curare
Medications to administer an unconscious child:
Administer _____ to relax the child so that they do not feel pain. This will also help to decrease ICP because pain causes increased ICP. ON EXAM.
Morphine
Indications for intracranial pressure monitoring:
1. Showing signs and symptoms of increased ICP.
2. Glasgow coma scale less than _____.
3. Glasgow coma scale _____ with respiratory distress.
4. Deteriorating neurological condition.
5. Decreased ______.
The RN should use subjective judgment.
Ex. In patients with hydrocephalus or a traumatic brain injury the doctors anticipate that the swelling could worsen.
seven
eight
LOC
Nursing care for child with increased intracranial pressure:
- Positioning > Raise the HOB to 30°. Keep the head facing midline be careful with NOT to stimulate the _____ area.
- Eliminate or minimize any environmental _____ or _____ and decrease amount of family that comes in one visit to decrease mouse or make sure that everybody’s QUIET.
- Avoid activities that may increase ICP such as ______.
belly
noise or lights
suctioning
Altered pituitary secretion accompanies a lot of CNS disorders and diseases:
___________ > They are NOT dehydrated. This often goes misdiagnosed. Decreased URINE OUTPUT with HYPONATREMIA and HYPOOSMOLALITY is an indication. Recognition is the FIRST NURSING PRIORITY. ON EXAM.
Syndrome of inappropriate antidiuretic hormone
Vasopressin medications can cause _______.
SIADH
Treatment of SIADH:
Implement a ________.
Observe for electrolyte imbalance. Ex. Hyponatremia.
FLUID RESTRICTION
During _____ that is caused by CNS malfunction in the unconscious child the parents will notice that the child is oliguric and think dehydration and begin to give water. Educate the parents that the patient is not dry. Patient education is important.
SIADH
