Chapter 27: Alterations In Neurological Function Flashcards
(35 cards)
Why are infants and young children at higher risk for brain and spinal cord injuries?
Their skull and brain grow and develop rapidly during early childhood. Developing anatomic structures make them more vulnerable to injury.
What are the causes of altered mental status in children?
Infection, Trauma, Poisoning, Seizure, Alcohol or substance use, Diabetic ketoacidosis (DKA).
What are the key components of a pediatric neurological assessment?
History, Physical exam, Alertness/behavior, Levels of consciousness (LOC).
What is the most important indicator of neurologic dysfunction?
Level of consciousness (LOC).
What specific assessments are included in a neurological exam?
Glasgow Coma Scale (GCS), Vital signs, Skin, Eyes (pupil assessment), Posture.
What is flexor posturing (decorticate) and what does it indicate?
Rigid flexion, associated with lesions above the brainstem in the corticospinal tracts.
What is extensor posturing (decerebrate) and what does it indicate?
Rigid extension, associated with lesions of the brainstem.
What are seizures?
Abnormal electrical discharges in the brain that cause involuntary movement and behavior.
What are the types of seizures and their characteristics?
Absence seizures: Brief LOC, may resemble daydreaming, lip smacking, or twitching. Partial seizures: Occur in one hemisphere; symptoms depend on the affected brain region. Generalized seizures: Affect both hemispheres; bilateral spasms with impaired consciousness. Febrile seizures: Triggered by fever >101°F (38.3°C), occur mostly in children 6 months to 5 years, usually last less than a minute but can last up to 15 minutes.
How do partial seizures present?
May be abrupt or unprovoked. May have an aura. Can progress to a generalized seizure.
What are the phases of generalized seizures?
Tonic phase: Muscle contraction. Clonic phase: Rhythmic jerking movements.
What is status epilepticus?
A seizure lasting more than 30 minutes.
What needs to be monitored for prolonged seizures (>15 minutes)?
Electrolytes, glucose, blood gases, temperature, blood pressure.
What is the postictal period?
The recovery period after a seizure, during which the patient may have decreased LOC.
What are the key nursing interventions for seizures?
Maintain airway (do not put anything in the mouth). Jaw thrust may be helpful. Ensure safety (remove hazards from the environment). Administer medications (Benzodiazepines are 1st-line, AEDs if needed). Provide emotional support to family and patient. Educate about medication adherence.
What is meningitis?
Inflammation of the meninges covering the brain and spinal cord.
What are the two types of meningitis and their differences?
Bacterial: More virulent, can be fatal, infants are at greatest risk. Viral: Symptoms are similar to bacterial but milder, usually results in full recovery.
What are the common bacterial infections that can lead to meningitis?
Otitis media, Sinusitis.
What symptoms are seen in young children with meningitis?
Hypothermia, Change in feeding pattern, Vomiting, Diarrhea, Bulging or flat anterior fontanelle, Onset may be sudden or gradual over 1-2 days.
What symptoms are seen in older children with meningitis?
Fever, Altered LOC, Irritability, Muscle or joint pain, Headache, Nuchal rigidity (neck stiffness), Kernig and Brudzinski signs (meningeal irritation).
How is bacterial meningitis treated?
Antibiotics based on suspected or likely pathogen.
How is viral meningitis treated?
Supportive care. Antibiotics are given until bacterial meningitis is ruled out.
What are key nursing considerations for meningitis?
Assessment, Medication administration, Environmental safety.
What is hydrocephalus?
An imbalance between production and absorption of CSF, leading to increased CSF volume in the brain.
