Ch. 45 Cerebral Dysfunction

Question 1

As intracranial pressure increases does level of conscious increase or decrease

Answer 1

Decrease

Question 2

Define coma

Answer 2

No motor or verbal response or extension posturing to noxious stimuli

Question 3

Define Stupor

Answer 3

Remaining deep sleep, slow response to stimuli

Question 4

Define lethargy

Answer 4

Limited spontaneous movement, sluggish speech, drowsy, falling asleep easily

Question 5

When should the Babinski reflex disappear in infants

Answer 5

Around 1 years old- 18months

Question 6

Define obtundation

Answer 6

Arousal with stimulation

Question 7

What are the three categories that make up the Glasgow coma scale

Answer 7

Eye opening
Verbal response
Motor response

Question 8

A score of a 15 on the Glasgow coma scale indicates

Answer 8

Unaltered LOC

Question 9

A score of 8 or below on the Glasgow Coma scale indicates

Answer 9

coma

Question 10

A score of 3 on the Glasgow coma scale indicates

Answer 10

Deep coma

Question 11

T/F a sudden appearance of a fixed and dilated pupil is a neurologic emergency

Answer 11

True

Question 12

Why is the oculovestibular (caloric test) never performed on an awake child

Answer 12

It invokes the installation of ice water into the ear of a comatose child, it is painful

Question 13

What is the priority nursing intervention when a child is unconscious

Answer 13

Establish and adequate airway

Question 14

What is Mannitol used for

Answer 14

Treat children who has increased ICP resulting from cerebral edema

Question 15

Define concussion

Answer 15

Most common head injury, alteration in neurologic or cognitive function with or without loss of consciousness

Question 16

Define Contusion

Answer 16

Represent petechial hemorrhages or localized bruising along superficial aspects of brain

Question 17

Define linear fracture

Answer 17

Single fracture line that starts at the point of maximum impact but does not cross suture lines

Question 18

Define depressed fracture

Answer 18

Are those in which the bone is broken locally, usually into several irregular fragments that are pushed inward causing pressure on bone

Question 19

Define Comminuted fracture

Answer 19

Consist of multiple associated linear fractures

Question 20

Define open fractures

Answer 20

cause communication between the skull and the scalp or mucosa of the URT

Question 21

Define growing fractures

Answer 21

Skull fractures associated with an underlying dual tear that may be caused by cyst

Question 22

Define epidural Hemorrhage

Answer 22

Bleeding b/w the Duran and the skull to form a hematomas, this bleeding causes the Duran to be stripped from bone, forcing underlying brain contents downward and inward as the brain expands

Question 23

Define subdural hemorrhage

Answer 23

Bleeding b/w the Duran and the arachnoid membrane(cerebrum), usually as a result of rupture of cortical veins that bridge the subdural space

Question 24

Deep rapid, periodic, intermittent gasping respiration, slowing pulse, fluctuations in blood pressure are signs of

Answer 24

Brainstem involvement brain injury

Question 25

Can bacterial meningitis be prevented

Answer 25

Yes with use of H influenza type B vaccine

Question 26

What are some of the clinical manifestations of ICP in infants

Answer 26

Bulging fontanel, irritability, high pitched cry, poor feeding, setting sun sign

Question 27

What are some of the clinical manifestations of ICP in children

Answer 27

Headache, nausea, diplopia, blurred vision, seizures increased sleeping, inability to follow simple commands

Question 28

What are late signs of ICP in infants and children

Answer 28

Bradycardia, extension, posturing, cheyne-stokes restorations, alteration in pupil size

Question 29

What are some clinical signs that confirm meningitis in a neonate

Answer 29

Bulging anterior fontanel, weak cry, poor muscle tone