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Pediatrics > Week 3 Cerebral Dysfunction > Flashcards

Week 3 Cerebral Dysfunction Flashcards

1
Q

An infant with ICP will have a _______

A

high pitched whimper

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2
Q

With a Nero assessment. ______ is most important

A

History

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3
Q

What is decorticate posturing?

A

Curling up protects the core

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4
Q

What is decerebrate posturing?

A

Curls outward

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5
Q

What is Kernig’s sign and what is it a positive indicator of?

A

Pain when the knees are bent up.

Positive for inflamed meninges

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6
Q

What is brudzinski’s sign and what is it positive for?

A

Pain when flexing the head forward. Positive for inflamed meninges

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7
Q

Changes in the _____ are critical indicators of Neuro problems

A

Glascow Coma scale.

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8
Q

What are five major cerebral dysfunctions in pediatric patients?

A
  • Head injury
  • Meningitis
  • Seizure disorders
  • Migraine
  • Hydrocephalus
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9
Q

Why are head injurys in children wors than adults *anatomically speaking”

A

Because the skull of a child is softer and less rigid. Their skull doesn’t crack it caves.

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10
Q

Why can infants handle increased ICP better than children?

A

Because they don’t have fused skulls yet

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11
Q

During a neuro assessment of a patient with a head injury, changes in LOC A and )’s, neuro signs could indicate what four major things?

A
  • Hypoxia
  • Decreased perfusion
  • Shock
  • increased ICP
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12
Q

What is Cushing’s triad?

A

It is 3 signs that develop late in instances of increased ICP

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13
Q

What are the three parts of cushions triad?

A
  • INcreased systolic BP (with widening pp)
  • Bradycardia
  • Irregular respirations (breathing center disrupted)
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14
Q

Why is it important to assess the temperature of a patient with a head injury?

A

Because thermoregulators may be disrupted from the brain injury and could lead to extreme fever

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15
Q

What is one major intervention for children in a coma?

A

Aggressive AROM

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16
Q

What are the three types of skull fractures?

A

Linear, Depressed, and Basilar

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17
Q

What are the possible complications of a linear skull fracture?

A

UNderline Brain injury

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18
Q

What are the possible complications of a depressed skull fracture?

A
  • Bleeding
  • Dural laceration
  • tissue injury
  • infection if open wound
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19
Q

When do most depressed skull fractures occur and why?

A

The summer time

-CHildren are using more blunt objects during play

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20
Q

How is a depressed skull fracture treated?

A

Surgical repair

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21
Q

What are three major indicators of a basilar skull fracture?

A
  • CSF leaking from nose and/or ears
  • Periorbital ecchymosis (raccoon eyes)
  • Bruising behind ears (battle sign)
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22
Q

What is one main intervention for a basilar skull fracture?

A

Bed rest until CSF leak stops

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23
Q

What are the major complications of a basilar skull fracture?

A
  • Meningitis
  • Hearing loss
  • facial paralysis
  • vertigo
  • tinnitus
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24
Q

All cases of meningitis are treated as ___ until confirmed otherwise

A

Bacterial

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25
Q

How does CSF appear in viral meningitis?

A

Clear

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26
Q

viral meningitis can be abrupt or _____

A

gradual

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27
Q

how is viral meningitis treated?

A

Through the treatment of the symptoms

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28
Q

What are the four major signs of viral meningitis in infants?

A
  • Irritable
  • Lethargic
  • Vomiting
  • Change in appetite
29
Q

what are the major signs of viral meningitis in older children?

A
  • Preceded by a nonspecific febrile illness
  • Headache
  • Muscle ache
  • malaise
  • N/V
  • Photophobia
  • nuchal/spinal rigidity
30
Q

What are theree causes of Bacterial meningitis

A
  • H-influenza
  • Strep
  • neisseria
31
Q

How is H-influenza prevented?

A

Hib vaccine

32
Q

What are some Bacterial meningitis specific signs in an infant?

A
  • High-pitched cry
  • Temp regulation failure
  • Floppy baby
33
Q

What are some signs/symptoms of Bacterial meningitis in infants

A
  • poor/sick feeding
  • Vomiting
  • High pitched cry
  • bulging fontanel
  • Fever or hypothermia
  • poor muscle tone
34
Q

what are some signs/symptoms of Bacterial meningitis in older children

A
  • Abrupt onset
  • Fever/chills
  • HA
  • Nuchal rigidity (neck)
  • Irritable
  • agitation
  • rash
  • seizure
  • drowsy + kerning or brudzinski’s sign
  • Opisthotonus posture
35
Q

What are the main nursing interventions involved with caring for a child with Bacterial/viral meningitis

A
  • Minimize ICP by elevating HOB and monitoring fluids in, maybe an icepack on head
  • Monitor of cereal edema
  • Use antipyretics do not use opioids
  • Monitor for complications
36
Q

What is epilepsy?

A

Chronic seizure disorder

37
Q

What are the two types of seizures?

A

Generalized and focal

38
Q

What is a generalized seizure?

A

One that occurs in both hemispheres of the brain

39
Q

What is a focal seizure?

A

one that occurs in on hemisphere of the brain

40
Q

What are some causes of seizure disorder in infants?

A
  • perinatal hypoxia
  • hypoglycemia
  • cong. diseases
  • infections
  • metabolic or degenerative diseases
  • drug withdraw
41
Q

What are some causes of seizures in older children?

A
  • Febrile infections
  • Head injury
  • Lead toxicity
  • Drugs
  • Genetic disorder
  • neoplasms(tumor)
42
Q

What does the term tonic-clonic mean

A

Also known as a grand mal seizure.

43
Q

What are the characteristics of a tonic-clonic seizure?

A

Loss of consciousness occurs first and lasts about 10 to 20 seconds, followed by muscle convulsions that usually last for less than two minutes.

44
Q

What are some characteristics of focal seizures?

A

Can be motor or non-motor

  • each person is different
  • can cause odd behaviors or uncontrolled movements
  • can cause blank stares
  • can cause emotions
  • Sensory distortions
  • Basically, they can be anything
45
Q

What are some major assessment data to collect from a patient with a seizure disorder?

A
  • Order of events and duration
  • Participatory events
  • What body parts are involved
46
Q

You also need to ask what normally happens ____ the seizure? Why?

A

After
because some patients will have decreased LOC, motor, speech, and orientation after. this puts them at a high risk for injury

47
Q

A patient is have a seziure. What do you do?

A
  • Help them to the ground of standing
  • Place them in the rescue position
  • Protect their airway
  • Protect their head/neck
  • Wait of the seizure to end
48
Q

What is one very important consideration about drug administration for seziure medications?

A

TheyApr have a very short window of administration and need to be given as close to the time prescribed as possible

49
Q

Aprox ____ of migraine sufferers have their first attack before ____

A

20% 5th birthday

50
Q

How does a migraine appear in children 5 and under?

A
  • They look ill
  • have abdominal pain
  • vomit
  • strong need to sleep
  • irritable
  • they cry or rock
  • seak somewhere dark and quiet
51
Q

How do migraines appear in children 5-10?

A
  • Headache
  • nausea
  • abdominal cramp
  • vomiting
  • Photo, phono, osmophobia
  • need to sleep
  • pale with dark circles
  • tearing
  • thirst
  • sweating
  • swollen
  • increased urination
  • diarrhea
52
Q

What are some teaching points for migraines?

A

Keep a diary of triggers

the child may outgrow them. it happens

53
Q

What is the main reason we measure child head circumference?

A

to detect hydrocephaly

54
Q

What causes hydrocephaly?

A

50% is idiopathic

the rest is associated with meningitis, trauma, intraventricular hemorrhage, or myelomeningocele

55
Q

What is the patho of hydrocephaly?

A

It is an imbalance of the production and absorption of CSF. this overproduction causes increased buildup in the brain in leads to increased ICP

56
Q

WHat are the two types of hydrocephaly

A

Communicating and non-communicating

57
Q

What is communicating hydrocephaly

A

Normal production of CSF with under absorption

58
Q

what is non-communicating hydrocephaly?

A

CSF traped in ventricles

59
Q

What are the s/s of hydrocephaly in infants?

A

Splitting sutures, bulging fontanels, irritability, and increased head circumference

60
Q

what are the s/s of hydrocephaly in older children?

A
  • Setting sun eyes
  • seizures
  • irritability
  • increased head circumference
61
Q

What is the treatment for hydrocephaly?

A

Ventro peritoneal shunt

62
Q

Why do we NEVER give children under 18 aspirin?

A

BEcause it can cause Reye syndrome

63
Q

What is Reye syndrome?

A

A rare syndrome caused by the interaction of a virus and aspirin. The interactions causes Metabolic encephalopathy and fatty liver

64
Q

What are the key nursing management for Reye syndrome?

A
  • PReventions
  • Strict I’s and O’s
  • Control cerebral edema
  • When the child wakes up they may have mental defects from brain damage
65
Q

What is Guillian Barre?

A

An inflammatory syndrome associated with immunizations and viruses

66
Q

What is the patho of guillian barre?

A

Acute inflammatory demyelinating neuropathy occurs.

Causing reduced motor function and reflexes in a distal to proximal pattern until total paralysis occurs.

67
Q

How is Guillian Barre treated?

A

IV immune globulin (very expensive)

68
Q

What are the nursing managements for Guillian Barre?

A
  • IV meds
  • Prevent complications from immobility
  • monitor respiratory status
  • Nutritional support
  • Emotional support

Pediatrics (20 decks)

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