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Nursing, LPN, Year 2 > X Neuro: Child (Ms Si) > Flashcards

X Neuro: Child (Ms Si) Flashcards

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1
Q

Meningitis

A
  • Infection and Inflammation of meninges (surr Brain/SC)
  • begins in resp tract and travels into blood then to Brain/SC
  • Causes: Bacterial, Viral, Fungal (adults/pedes)
  • Preventable w Vaccine (don’t mix vaccines)
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2
Q

Newborn

A

birth - 4 wks

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3
Q

Infant

A

1 mos - 12mos

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4
Q

Bacterial Meningitis: Causes

A

Newborn: group B strep; E.coli, Listeria, monocytogenes
Infant: strep pneumonia, Neisseria meningitides, Haemophilus influenza type b
Adolescents/Young Adults: Neisseria Meningitidis, Streptococcus pneumoniae

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5
Q

Meningitis: Infant: SS

A

-Irritability
-fever
-lots of sleeping
-poor feeding
-high pitch cry
-opisthotonos (arching of back)
-cries when picked up/being held
-inconsolable crying
-bulging Fontanelle
-noticeably diff temp
(non specific as SS are of a normal irritable child)

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6
Q

Meningitis: 1yr and older: SS

A
  • neck/back pain
  • HA
  • Sleepiness
  • confusion
  • irritability
  • F
  • refusal to eat
  • DEC LOC
  • Sz
  • photophobia
  • N/V
  • nuchal rigidity
  • Kernig’s / BreZinskys sign
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7
Q

Meningitis:Dx

A
  • med Hx
  • analysis of CSF (lumbar punc, if meningitis present w show UP WBC, UP protein, LO BG, cloudy
  • CT head ( IICP? If so don’t do lumbar px, treat w Abx)
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8
Q

Meningitis: MM

A
  • IV Abx
  • MED: Dexamethasone (steroid, LO inflam)
  • Bed Rest
  • fluid (isolation b/c airborne, 24hrs once IV Abx started
  • Anticonvulsants
  • Antipyretics
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9
Q

Meningitis: NI

A
  • rapid ID of bacterial Men
  • **Admin Abx
  • Promote rest
  • DEC environ stimuli (quite peaceful setting)
  • Neuro checks
  • Monitor VS
  • Monitor I/O
  • Provide support for child and fam
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10
Q

Bacterial Meningitis: Complications

A

-RARE
-hearing loss
-mem diff
-learning diff
-brain damage
-gait problems
-Sz
-Renal failure
-Death
-30% have neuro deficits after disease
Pg 1041

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11
Q

Hydrocephalus (water brain)

A
  • buildup of excess CSF on brain

- CAUSE: imbalance of production and absorbtion

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12
Q

Brain Review

A
  • 4 cavities (Ventricles), produce CSF
  • CSF circulates thru brain, SC and nourish CNS before reabsorption into bloodstream
  • CSF made in Choroid Plexuses (lateral /4th ventricle)
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13
Q

What part of brain is CSF made in?

A

Cerebrospinal fluid (CSF) is produced by the choroid plexus in the lateral, third, and fourth ventricles and circulates through the subarachnoid space between the arachnoid mater and the pia mater.

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14
Q

Hydrocephalus: causes

A
  • obstruction in ventricle system stops CSF from flowing
  • bloodstream not adequately re-absorbing CSF d/t hemorrhage in subarachnoid space. SA space has absorptive membrane, if brain is bleeding, it covers membrane and blocks re absorption of CSF.
  • child’s brain produces excessive CSF d/t tumor in choroid plexus?
  • Atresia (no duct or canal in ventricles)
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15
Q

Atresia

A

absence of a duct opening of canal

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16
Q

Hydrocephalus: SS

A
  • huge head
  • eyes bulge out
  • downward cast gaze
  • prominent scalp veins
  • developmental delays
  • constant sleepiness
  • diff remaining alert
  • poor appetite
  • irritability
  • severe V
  • Sz
17
Q

Hydrocephalus: Dx

A

-US
-MRI
-CT Scan
If prenatal, they can Dx in 3rd trimester

18
Q

Hydrocephalus: Rx

A

-shunt VP (peritoneal) or VA (atria) shunt
(fluid exits brain and delievered into peritoneum or atria)
-endoscopic 3rd ventriculostomy (drill into ventricle, drain)

19
Q

Hydrocephalus: NI

A
  • neuro checks
  • monitor IICP, VS, I/O
  • emotional support and shunt education on complications and SS
20
Q

Is a shunt a LT or ST fix?

A

Long Term

21
Q

Shunt Complication Education

A

SEE PIC. basically all the SS of Hydrocephalus as the shunt malfunction would mean no relief from HE

22
Q

Spina Bifida (split spine)

A
  • permanently disabling birth defect
  • defect in closure of neural tube
  • neural tube develops into brain and sc
23
Q

Neural Tube

A

develops into brain / SC

24
Q

Spina Bifida: Types

A
  • Spina Bifida Occulta (minor, most don’t even know, dimpling at coccyx, tuft hair, lump of fat)
  • Meningocele
  • Myelomeningocele (MOST SEVERE)
25
Q

Spina Bifida: Meningocele

A
  • meninges push out thru neural tube defect (only meninges push thru)
  • SC develops normally
  • Min - NO neural defects
  • can be corrected
26
Q

Spina Bifida: Myelomeningocele

A

-SC, meninges, CSF and nerves protrude

This is the type lay people are usually referring to when they say Spina Bifida

27
Q

Spina Bifida: Myelomeningocele: SS

A
  • absent motor/sensory fx beyond defect
  • paralysis
  • incontinence
  • hydrocephalus in 80% cases
28
Q

Spina Bifida: Myelomeningocele: Rx

A
  • position on abd not back
  • dressing: cover sac with moist saline guaze
  • Sx
  • shunt if hydrocephalus present (80%)
29
Q

Lead Poisoning

A
  • preventable
  • blood level OVER 5 mcg/dl
  • source: lead based paint /lead contaminated dust
  • @risk: all children under 6
30
Q

Lead Poisoning (more facts)

A
  • excreted via GI/GU
  • accum in bone
  • chronic ingestion –> lead deposits into circulatory system
  • 90% attach to erythroceytes (RBC)
  • takes 2ce as long to excrete vs accumulate
31
Q

Lead Poisoning: System Effects

A
  • Hematologic System: prevents formation of HgB–> anemic
  • Renal System: damages tubules –> renal failure
  • CNS: UP membrane permeability –> UP ICP –> tissue ischemia/atrophy –> brain damage
32
Q

Lead Poisoning: SS

A
  • Anemia
  • PICA (eating non edible things)
  • Anorexia
  • lethargy
  • learning diff
  • DEC attention
  • hearing diff
  • growth/dev failure
33
Q

Lead Poisoning: Rx

A
  • remove source of contamin
  • balanced nutrition (absorb less lead that those w unbalanced nutrition)
  • chelation therapy (levels 45 an UP)
  • no MED Rx recom for kids levels lower than 45
  • Iron supp
34
Q

Neonatal Abstinence Syndrome (NAS)

A
  • occurs when deloping feturs is exposed to opiods, antidepress, benzodiazepines, ETOH
  • after birth, infant thru withdrawal
  • d/t drug addicted mom
35
Q

Neonatal Abstinence Syndrome (NAS): SS

A
  • poor intrauterine growth
  • premature birth
  • low birth weight
  • Sz
  • Birth defects
  • develop delays
  • learning diss
  • low IQ
36
Q

Neonatal Abstinence Syndrome (NAS): more SS

A
  • tremors
  • irritability
  • sleep problems
  • high pitched cry
  • tight muscle tone
37
Q

Neonatal Abstinence Syndrome (NAS): even more SS

A
  • hyperactive reflexes
  • yawning
  • stuffy nose
  • poor feeding/sucking
  • V/D/dehydration
  • sweating
  • F, labile Temp
  • excessive sucking
38
Q

Neonatal Abstinence Syndrome (NAS): NI

A
  • quiet envnt
  • swaddling
  • pacifier (for excessive suck)
  • IV fluid
  • UP calories (b/c burn lots of calories w excess crying)
  • BREASTFEED
39
Q

Neonatal Abstinence Syndrome (NAS): MEDS

A
  • Morphine (Opiods)
  • Methadone
  • Phenobarbital

Nursing, LPN, Year 2 (27 decks)

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