Chapter 52: The Child with a Neurologic Alteration

Question 1

Causes include increased ICP, infection, and tumors

Answer 1

seizures

Question 2

Symmetric and rhythmic, consisting of alternating contraction and relaxation of major muscle groups

Answer 2

clonic phase

Question 3

Results after an injury that may have occurred prenatally, perinatally, or postnatally

Answer 3

cerebral palsy

Question 4

Treatment goals for a child with hydrocephalus is to _________________ and ________________ from increased ICP.

Answer 4

reduce disability, prevent death

Question 5

Saclike protrusion is filled with CSF, meninges, nerve roots, and spinal cord

Answer 5

spina bifida cystica: myelomeningocele

Question 6

Treatment for rapidly-progressing Guillain-Barré Syndrome

Answer 6

IV immunoglobulin (IVIG)

Question 7

Symptoms include photophobia, phonophobia, nausea, vomiting, and irritability

Answer 7

migraine

Question 8

Cushing’s triad

Answer 8

widening pulse pressure
bradycardia
irregular respirations

Question 9

Severe complication of increased ICP

Answer 9

brain stem herniation

Question 10

Key diagnostic feature is lumbar puncture

Answer 10

meningitis

Question 11

The ________________, which later forms the ___________________, is formed in the first few weeks of pregnancy before the mother knows that she is pregnant.

Answer 11

neural tube, spinal cord

Question 12

If a brain bleed occurs without a fracture in an infant or young child, suspect ___________________. This is a sign of ________.

Answer 12

shaken baby syndrome, abuse

Question 13

Patients with spina bifida are at an increased risk of developing ________ allergies

Answer 13

latex

Question 14

If fatal, people with Guillain-Barré Syndrome will most often die from ____________________ such as __________________

Answer 14

respiratory complications, respiratory paralysis

Question 15

Only a limited functional area in one hemisphere of the brain is involved with symptoms seen on only one side of the body

Answer 15

focal seizure

Question 16

Common in children who play sports

Answer 16

concussion

Question 17

Very brief episodes of altered consciousness with typically no muscle activity

Answer 17

absence seizures

Question 18

Myelomeningoceles are the most _________ form of spina bifida and are often accompanied by a diagnosis of ________________.

Answer 18

severe, hydrocephalus

Question 19

Treat status epilepticus with with benzodiazepines: _____________, _____________, ______________
Then give __________________
Then give ____________________

Answer 19

diazepam, lorazepam, midazolam, phosphenytoin, phenobarbital

Question 20

____________ (an osmotic diuretic) or _________ saline can help decrease ICP

Answer 20

Mannitol, hypertonic

Question 21

Sustained, generalized stiffening of muscles, including diaphragm, lasting a few seconds

Answer 21

tonic phase

Question 22

Mildest form of spina bifida with few manifestations other than a tuft of hair or dimple

Answer 22

spina bifida occulta

Question 23

Raccoon eyes and Battle sign indicate ____________________.

Answer 23

basilar skull fracture

Question 24

Monitor CBC, liver enzymes, and medication levels closely with these medications

Answer 24

antiepileptic medications

Question 25

lacks ability to think clearly and rapidly

Answer 25

confused

Question 26

Alternative treatment for epileptic seizures

Answer 26

strict ketogenic diet

Question 27

Manifestations in an infant include poor feeding or vomiting; irritability, restlessness, or lethargy; bulging fontanel; high-pitched cry; increased head circumference; separation of cranial sutures; distended scalp veins; eyes deviated downward ("setting sun" sign); and increased or decreased response to pain.

Answer 27

increased ICP

Question 28

Most common infectious process affecting CNS

Answer 28

meningitis

Question 29

Saclike protrusion containing meninges and CSF

Answer 29

spina bifida cystica: meningocele

Question 30

Manifestations in a child include headache, diplopia, mood swings, slurred speech, papilledema (after 48 hours), altered LOC, and nausea and vomiting (especially in morning).

Answer 30

increased ICP

Question 31

Before the suture lines have closed, the infant with hydrocephalus will have a(n) _________________ with rapidly growing ____________________________.

Answer 31

enlarged head, head circumference

Question 32

A ___________________________ is placed to drain excess CSF. It enters the _____________ and follows a drain into the ____________________ where it is reabsorbed and excreted

Answer 32

ventriculoperitoneal shunt, ventricles, peritoneal cavity

Question 33

awakens easily but exhibits limited responsiveness

Answer 33

lethargic

Question 34

Develops as the result of an imbalance of production and absorption of CSF

Answer 34

hydrocephalus

Question 35

Brain bleed between the dura mater and the brain Often (arterial, venous)

Answer 35

subdural hematoma, venous

Question 36

Characterized by rapidly progressing limb weakness (progressive ascending paralysis), loss of deep tendon reflexes, and acute demyelinization of the nerves

Answer 36

Guillain-Barré Syndrome

Question 37

Can be a complication of neurosurgery, systemic infection, or sinus or ear infection

Answer 37

meningitis

Question 38

two types of spina bifida cystica

Answer 38

meningocele, myelomeningocele

Question 39

Consists of brief paroxysmal behavior caused by excessive discharge of neurons

Answer 39

seizure

Question 40

May originate as a viral infection or reaction to influenza vaccine

Answer 40

Guillain-Barré Syndrome

Question 41

Another concussion occurs before first concussion has healed

Answer 41

second impact syndrome

Question 42

Cause abrupt arrest of activity and impairment of consciousness

Answer 42

tonic-clonic seizures

Question 43

Lack of ______________ in the early days of pregnancy is thought to result in spina bifida

Answer 43

folic acid

Question 44

Prolonged seizure activity that lasts more than 5 minutes or multiple seizures in a brief period

Answer 44

status epilepticus

Question 45

Ventricles within brain become dilated and result in symptoms of ICP

Answer 45

hydrocephalus

Question 46

No herniation of spinal cord or meninges

Answer 46

spina bifida occulta

Question 47

lacks ability to recognize place or person

Answer 47

disoriented

Question 48

Babies with spina bifida cystica must be born by this method

Answer 48

Cesarean section

Question 49

_________________ extremities are common in myelomeningoceles due to the restriction of fetal movement in utero. One example of this is ____________.

Answer 49

Deformed, club foot

Question 50

Mild to incapacitating headache sometimes preceded by an aura and can coexist with depression and anxiety

Answer 50

migraine

Question 51

sleeps and, once aroused, has limited interaction with environment

Answer 51

obtunded

Question 52

Causes include head injuries, infection, hypoxia, tumors, aneurysms, or hydrocephalus

Answer 52

increased ICP

Question 53

Never give ______________ to a child with increased ICP because it can cause ____________

Answer 53

lumbar puncture, herniation

Question 54

Headache characterized by generalized pain, band-like tightness or pressure, tight neck muscles, and sore scalp

Answer 54

tension headache

Question 55

This treatment may be implemented if child is not responsive to antiepileptic medications and seizure activity is great

Answer 55

Vagus nerve stimulator

Question 56

Diagnosed when the pressure within the skull is sustained at ___ mmHg for ___ minutes or more

Answer 56

Increased ICP, 20, 5

Question 57

Cause abrupt loss of postural tone, impairment of consciousness, confusion, lethargy, and sleep

Answer 57

atonic seizures

Question 58

These can occur if temperature rises rapidly

Answer 58

febrile seizures

Question 59

Often accompanied by comorbidities such as cognitive impairment; hearing, speech, and visual impairments; and seizures.

Answer 59

cerebral palsy

Question 60

Chronic, nonprogressive disorder of posture and movement that involves difficulty controlling muscles

Answer 60

cerebral palsy

Question 61

Brain bleed between skull and dura mater Often (arterial, venous) and may require surgical evacuation

Answer 61

epidural hematoma, arterial

Question 62

severe form of spinal bifida

Answer 62

spina bifida cystica

Question 63

vigorous stimulation produces no response

Answer 63

coma

Question 64

Color of CSF should always be _______. If not, infection is indicated.

Answer 64

clear

Question 65

Most commonly congenital but can result from trauma, hemorrhage, brain tumors, or meningitis

Answer 65

hydrocephalus

Question 66

Autoimmune neurologic disorder of peripheral nervous system

Answer 66

Guillain-Barré Syndrome

Question 67

Another term for cerebral palsy (before age of 2)

Answer 67

static encephalopathy

Question 68

Brief, random contractions of a muscle group, followed by loss of muscle tone and forward falling

Answer 68

myoclonic seizures

Question 69

Treatments for cerebral palsy include ______________ via a pump, __________, and ________ injections.

Answer 69

intrathecal baclofen, benzodiazepines, Botox

Question 70

awake, alert, oriented, interacts with environment

Answer 70

full consciousness

Question 71

Symptoms include headache, photophobia, nuchal rigidity, and altered LOC

Answer 71

meningitis

Question 72

Manifestations vary, but most cases show persistent primitive reflexes, delayed gross motor development, and abnormal muscle tone.

Answer 72

cerebral palsy

Question 73

requires stimulation to arouse

Answer 73

stupor

Question 74

Congenital neural tube defects (NTD) that results in an incomplete closure of the vertebrae, which exposes the spinal cord

Answer 74

spina bifida

Question 75

impairment of reality with hallucinations possible

Answer 75

delirious