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Pediatrics > Care of Child w/ Neuro Disorders > Flashcards

Care of Child w/ Neuro Disorders Flashcards

1
Q

Types of Neurological Disorders in Children

A
  • structural disorders
  • seizure disorders
  • infectious disorders
  • trauma to neuro system
  • blood flow disruption disorders
  • chronic disorders
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2
Q

3-4 Weeks Gestation Neuro A&P

A

infection, trauma, teratogens, and malnutrition can cause physical defects and may affect normal CNS development

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3
Q

Birth Neuro A&P

A

cranial bones well developed, but not fused: increased risk for fracture

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4
Q

Child Neuro A&P

A

spinal cord is mobile; high risk for cervical spine injury

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5
Q

Factors Affecting Neuro Disease in Child

A
  • premature
  • difficult birth
  • infection during pregnancy
  • n/v, headache
  • changes in gait
  • falls
  • visual disturbance
  • recent trauma
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6
Q

What do we inspect/observe in child w/ Neuro Disorder?

A
  • LOC
  • vitals
  • head, face, neck
  • cranial nerve function
  • motor/sensory function
  • reflexes
  • increased intracranial pressure
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7
Q

If the child’s eyes are sunsetting what does that mean?

A

increased intracranial pressure

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8
Q

What is the earliest indicator of improvement or deterioration of neuro status?

A

Level of consciousness

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9
Q

Five States of Consciousness

A
  • full consciousness
  • confusion
  • obtunded
  • stupor
  • coma
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10
Q

Full Consciousness

A

child is awake and alert
oriented to time, place, and person
exhibits age appropriate behaviors

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11
Q

Confusion

A

disorientation exists

child may be alert but responds inappropriately to questions

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12
Q

Obtunded

A

child has limited responses to the environment and falls asleep unless stimulation is provided

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13
Q

Stupor

A

child only responds to vigorous stimulation

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14
Q

Coma

A

child cannot be aroused, even w/ painful stimuli

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15
Q

What neuro disorders would you do frequent vitals for?

A 
Cerebral infection
Increased ICP
Coma
Brain stem injury
Head injuries
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16
Q

Alterations in motor function may indicate what?

A

Certain neuro problems such as: increased ICP, head injury, and cerebral infections

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17
Q

What are the two important distinct types of posturing that may occur?

A

Decorticate posturing

Decerebrate posturing

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18
Q

Decorticate Posturing

A

occurs w/ damage of cerebral cortex
extreme rigid muscle tone
extremities flexed

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19
Q

Decerebrate Posturing

A

occurs w/ damage at the level of the brain stem
extreme rigid muscle tone
extremities extended and pronated

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20
Q

Cranial Nerve I

A

sense of smell
have child close eyes and tell you what they smell
NOT for infants

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21
Q

Cranial Nerve II, III, IV, VI

A

vision, motor control, eye movements, eye muscles

follow an object, visual acuity tests, check pupils

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22
Q

Cranial Nerve V

A

mastication muscles

sensation: pacifier, bite, light touch on face

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23
Q

Cranial Nerve VII

A

facial muscle, salivation, taste: smiles, cries, taste

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24
Q

Cranial Nerve VIII

A

hearing-response to voice, whisper

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25
Q

Cranial Nerve IX, X

A

motor impulses to heart, swallowing, gag reflex

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26
Q

Cranial Nerve XI

A

impulses to shoulders and pharynx-head position in sitting position, shoulder shrug

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27
Q

Cranial Nerve XII

A

impulses to tongue and skeletal muscles-tongue movement

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28
Q

How do we manage disturbed sensory perception?

A
  • assess for changes in sensory perception
  • monitor for risk of injury secondary to sensory changes
  • notify doctor/crnp of changes
  • assist child in learning adaptive methods
  • provide familiar sounds
29
Q

Infant Reflex Assessment

A

moro
tonic neck
withdrawal

30
Q

Common Lab and Diagnostic Tests

A 
lumbar puncture 
head and neck radiograph
fluoroscopy 
cerebral angiography 
ultrasound
CT scan
EEG
MRI
PET scan
ICP
31
Q

What are some medications used to treat neuro disorders?

A 
antibiotics 
anticonvulsants 
benzodiazepines 
analgesics
osmotic diuretics
corticosteroids
32
Q

What are some medical treatments used for neuro disorders?

A 
shunt placement 
ventilation
PT/OT/ST
external ventricular drainage 
ventricular tap
vagal nerve stimulator 
ketogenic diet
33
Q

Seizure Disorders

A

epilepsy
febrile seizures
neonatal seizures

34
Q

Epilepsy

A
  • two or more unprovoked seizures, which occur more than 24 hours apart
  • one unprovoked seizure and a chance of further seizures the same as the general recurrence risk after 2 unprovoked seizures, happening over the next 10 years
35
Q

What are some risk factors for Epilepsy?

A
  • family history
  • any complications during prenatal, perinatal, or postnatal periods
  • changes in developmental status or delays in milestones
  • any recent illness, fever, trauma, or toxin exposure
36
Q

What should be the goal for every child put on seizure meds?

A

use the fewest drugs w/ the fewest possible side effects for the control of seizures

37
Q

Nursing Management for Epilepsy

A

preventing injury
appropriate meds and treatment
education and support

38
Q

Common types of Seizures

A 
infantile spasms
absence
tonic-clonic 
myoclonic
atonic
simple partial
complex partial
status epilepticus
39
Q

Common types of Structural Defects

A 
Neural Tubal Defects
Microcephaly 
Arnold-Chiari Malformation
Hydrocephalus 
Intracranial Arteriovenous Malformation 
Craniosynostosis
40
Q

Examples of Neural Tube Defects

A

Spina bifida occulta
Myelomeningocele
Anencephaly
Encephalocele

41
Q

Anencephaly

A

small or missing brain

42
Q

Encephalocele

A

protrusion of the brain and meninges through the skull

43
Q

Microcephaly

A

head circumferencemore than 3 standard deviations below the mean

44
Q

Arnold-Chiari Malformation

A

Type 1/Type 2
Type 1- adolescents w/ neck pain and headaches
Type 2-at birth/infants

45
Q

Hydrocephalus

A

imbalance and absorption of CSF

CSF accumulates in the ventricles

46
Q

Intracranial Arteriovenous Malformation

A

rare congenital disorder

47
Q

Craniosynostosis

A

premature closure of the cranial sutures; complete closure of all sutures does not normally occur until late in childhood

48
Q

Premature closure of the cranial sutures can cause what?

A

inhibit brain growth and a distorted skull appearance will be evident

49
Q

Positional Plagiocephaly

A

asymmetry in head shape
encourage tummy time
avoid excessive use of car seat
may benefit from helmet

50
Q

Signs and Symptoms of Shunt Infection

A 
elevated vitals
poor feeding 
vomiting 
decreased responsiveness 
seizure activity 
signs of local inflammation along shunt tract
51
Q

Types of Infectious Disorders of Neuro System

A

Bacterial meningitis
Aseptic meningitis
Encephalitis
Reye Syndrome

52
Q

Encephalitis

A

inflammation of the brain that may also include an inflammation of the meninges and can be caused by protozoan, bacteria, fungal or viral infection

53
Q

Bacterial Meningitis

A 
Medical emergency 
Prompt hospitalization 
LP and cultures 
IV antibiotics treatment 
Abrupt eruption of petechial or purplish rash
54
Q

Abrupt eruption of petechial or purplish rash can indicate what?

A

Meningococcemia

55
Q

Reye Syndrome happens primarily in who?

A

children less than 15 years old

56
Q

Reye Syndrome

A

brain swelling, liver failure, and death in hours

57
Q

What are some causes of Reye Syndrome?

A
  • viral illness-chicken pox, croup, flu, or upper resp infection
  • ingestion of salicylate-containing products w/in 3 weeks of start
  • Pepto-Bismol, Alka-Seltzer
58
Q

Risk Factors for Birth Trauma

A 
multiple deliveries 
large for date infants 
extreme prematurity 
large fetal head 
congenital anomalies
59
Q

Causes of Nonaccidental Head Trauma

A

Violent Shaking: shaken baby syndrome
Blows to head
Intentional Cranial Impacts against the wall, furniture, or the floor

60
Q

Cerebral Vascular Disorder is usually seen when?

A

after first month of life

61
Q

Periventricular/intraventricular hemorrhage is seen in who?

A

preterm infants and in infants up to 1 month of age

62
Q

Signs/Symptoms of Acute Stroke in Children

A

weakness on one side or hemiplegia
facial droop
slurred speech
speech deficits

63
Q

Migraines

A

specific type of headache-benign, recurrent throbbing headaches often accompanied by N/V, photophobia

64
Q

What are some causes of headaches?

A 
sinusitis
eyestrain
stress
brain tumors 
acute meningitis 
increased ICP
65
Q

What to do for headaches?

A
  • thorough physical exam w/ detailed neuro exam
  • may need neuroimaging to r/o tumor
  • keep headache diary
  • avoid caffeine, avoid dehydration
  • exercise, proper diet, sleep regulation
66
Q

Breath holding

A
  • benign behavior for children
  • stops inhaling/exhaling or hyperventilates
  • brain becomes anoxic
  • becomes cyanotic and passes out
  • resolves spontaneously
  • w/ LOC child begins breathing
67
Q

At what age is breath holding most likely to occur?

A

1-3 years old

68
Q

How long does the breath holding episode last?

A

30-60 seconds

69
Q

What should you check for w/ breath holding?

A

iron deficiency

Pediatrics (24 decks)

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