23 - Nervous System: Disorders, Dysfunction

Question 1

acute noninflammatory encephalopathy and hepatopathy that follows a viral infection in children

Answer 1

Reye’s Syndrome

Question 2

pathology of the brain

Answer 2

encephalopathy

Question 3

pathology of the liver

Answer 3

hepatopathy

Question 4

There may be a relationship between __ during a viral flu or illness and the development of Reye’s syndrome.

Answer 4

the use of aspirin (acetylsalicylic acid)

Question 5

nuchal rigidity

Answer 5

stiff neck

Question 6

3 characteristics of Reye’s syndrome in childred

Answer 6

1. sudden onset of effortless vomiting
2. altered behavior, or
3. altered level of consciousness after a viral illness

Question 7

Reye’s Syndrome: In infants, (4) may occur approximately 1 week after a respiratory illness.

Answer 7

1. diarrhea
2. hypoglycemia
3. tachypnea with apneic episodes, and
4. seizures

Question 8

Reye’s Syndrome: Liver cell pathology causes an accumulation of __ in the blood. Toxic levels of ammonia cause cerebral manifestations (e.g., cerebral edema, increased intracranial pressure [ICP])

Answer 8

ammonia

Question 9

Reye’s Syndrome: Toxic levels of ammonia cause __

Answer 9

cerebral manifestations (cerebral edema, increased intracranial pressure [ICP])

Question 10

Reye’s Syndrome: The goals of TREATMENT include (4)

Answer 10

1. Reducing ICP, and 
Maintaining:
2. patent Airway
3. cerebral Oxygenation
4. Fluid - Electrolyte balance

Question 11

12 Cranial Nerves

Answer 11

1.

Question 12

Reye’s Syndrome: Observation for signs of bleeding is important because ___.

Answer 12

liver dysfunction causes blood-clotting abnormalities.

Question 13

Systemic response to infection with bacteria, and can also result from viral and fungal infections;

Answer 13

Sepsis

Question 14

Sepsis causes SIRS because of the __ that causes tissue damage.

Answer 14

endotoxin of the bacteria

Question 15

SIRS

Answer 15

systemic inflammatory response syndrome

Question 16

Untreated sepsis results in (3)

Answer 16

1. septic shock,
2. multiorgan dysfunction syndrome (MODS), and
3. death.

Question 17

Children with increased risk for developing sepsis

Answer 17

1. immune-compromised
2. neutropenia
3. in intensive care receiving invasive therapy

Question 18

Sepsis: 5 Manifestations

Answer 18

1. fever
2. chills
3. tachypnea
4. tachycardia
5. neurological signs (ex: lethargy)

Question 19

Sepsis: Ominous sign that may indicate cardiorespiratory arrest is about to occur.

Answer 19

Hypotension

Question 20

Sepsis: Laboratory test results (3)

Answer 20

1. positive blood cultures
2. reduced fibrinogen and thrombocyte
3. Immature WBCs

Question 21

Sepsis: Laboratory test result, ominous sign

Answer 21

neutropenia (

Question 22

Sepsis: 4 Nursing Responisbilities

Answer 22

Monitor:

1. Neuro status
2. VS
3. Observe for shock
4. Maintain strict precautions

Question 23

Sepsis: Medical Treatment

Answer 23

IV Antibiotics

Question 24

Sepsis: Prevention

Answer 24

2 months - 4 yrs

1. Immunization (Hib)
2. Vaccine (PCV)

Question 25

Inflammation of the meninges

Answer 25

Meningitis

Question 26

the covering of the brain and spinal cord

Answer 26

meninges

Question 27

Meningitis: Organisms may invade the meninges by (3)

Answer 27

1. (indirect) bloodstream (sepsis)
2. (directly) through ear (otitis media)
3. fracture of the skull

Question 28

Meningitis: Most common causative agent

Answer 28

H. influenzae

Question 29

Meningitis: 7 Significant symptoms

Answer 29

1. Severe headache
2. drowsiness, delirium
3. irritability, restlessness
4. fever, vomiting
5. nuchal rigidity
6. high-pitched cry (infant)
7. Coma (older child)

Question 30

Meningitis: Symptoms may be preceded by (2)

Answer 30

1. upper respiratory infection, and

2. several days of gastrointestinal symptoms (ex:poor feeding)

Question 31

Severe Meningitis: Involuntary arching of the back caused by muscle contractions

Answer 31

opisthotonos

Question 32

Meningitis: Diagnosis is confirmed by

Answer 32

examination of the CSF

Question 33

Meningitis: The acutely ill and lethargic child who develops __ must be referred for immediate follow-up care; this suggests meningococcal infection.

Answer 33

a rash with petechiae

Question 34

Congenital Infections: TORCH

Answer 34

T - Oxoplasmosis
O
R - ubella
C- ytomegalovirus
H - Herpes (1 and 2)

Question 35

Meningitis: Diagnosis

Answer 35

Spinal Tap (for specimen of CSF)

Question 36

Meningitis: CSF color (early/late)

Answer 36

clear > cloudy (rapid)

Question 37

Meningitis: Lab analysis (3)

Answer 37

1. High WBCs
2. Increased Protein
3. Decreased Glucose

Question 38

Meningitis: Medical Treament

Answer 38

1. IV Antibiotics (10-14 days)
2. IV Fluids, Electrolytes
3. Sedative - restlessness
4. Anticonvulsant (phenytoin/Dilantin)
5. Dexamethasone - reduce complications

Question 39

Meningitis: CARE (Hospitalization)

Answer 39

1. Single room (transmission-based precautions)
2. Dim lights
3. Quiet

Question 40

Meningitis: Nurse Responsibility

Answer 40

1. Neuro checks
2. VS
3. I/O
4. Organized care

Question 41

Meningitis: S/S of increased ICP

Answer 41

1. Slowed HR
2. Irregular Respirations
3. Increased BP
4. Change in Alertness
5. Muscle twitching

Question 42

inflammation of the brain

Answer 42

encephalitis