Chp 49 - Neurologic Disorder

Question 1

consists cranial nerves, spinal nerves, and the somatic and visceral divisions

Answer 1

peripheral nervous system

Question 2

consists of the brain, spinal cord, and the surrounding membranes or meninges

Answer 2

central nervous system

Question 3

components of cerebral function

Answer 3

-orientation
-immediate recall
-recent memory
-remote memory

Question 4

refers to whether children are aware of who and where
they are, and what day it is

Answer 4

Orientation

Question 5

is the ability to retain a concept for a short time

Answer 5

Immediate recall

Question 6

covers a slightly longer period of time

Answer 6

Recent memory

Question 7

is long-term recall

Answer 7

Remote memory

Question 8

Refers to the ability to recognize an object by touch and tests sensory interpretation

Answer 8

Stereognosis

Question 9

The ability to recognize a shape that has been traced on the skin

Answer 9

Graphesthesia

Question 10

The ability to distinguish movement. Have the child close the eyes and extend hands in front

Answer 10

Kinesthesia

Question 11

list the 12 cranial nerves

Answer 11

I - olfactory
II - optic
III - oculomotor
IV - trochlear
V - trigeminal
VI - abducens
VII - facial
VIII - acoustic
IX - glossopharyngeal
X - vagus
XI - accessory
XII - hypoglossal

Question 12

function of cranial nerve I

Answer 12

sense of smell

Question 13

function cranial nerve II

Answer 13

vision

Question 14

function of cranial nerve III

Answer 14

motor control and sensation for eye muscles and upper eyelid

Question 15

function of cranial nerve IV

Answer 15

movement of major eye globe muscles

Question 16

function of cranial nerve V

Answer 16

mastication of muscles and some facial sensations

Question 17

function of cranial nerve VI

Answer 17

movement and muscle sense of eye globe

Question 18

function of cranial nerve VII

Answer 18

impulses for facial muscles, salivation, and taste

Question 19

function of cranial nerve VIII

Answer 19

equilibrium and hearing

Question 20

function of cranial nerve IX

Answer 20

motor impulses to heart; sensation from pharynx, thorax, and abdominal organs

Question 21

function of a cranial nerve X

Answer 21

swallowing and gag reflexes

Question 22

function cranial nerve XI

Answer 22

impulses to striated muscles of pharynx and shoulders

Question 23

function of cranial nerve XII

Answer 23

motor impulses to tongue and skeletal muscles; sensation from skin and viscera

Question 24

Introduction of a needle into the subarachnoid space (under the arachnoid membrane) at the level of L4 or L5 to withdraw CSF for analysis

Answer 24

Lumbar Puncture

Question 25

X-ray study of cerebral blood vessels that involves the injection of a contrast material into the femoral or carotid artery

Answer 25

Cerebral angiography.

Question 26

X-ray study of the spinal cord following the introduction of a contrast material into the SF by lumbar puncture to reveal the presence of space-occupying lesions of the spinal cord

Answer 26

Myelography.

Question 27

involves the use of X-rays to reveal densities at multiple levels or layers of brain tissue and to confirm presence of brain tumor or encroaching lesions

Answer 27

Computed tomography.

Question 28

Reflects the electrical patterns of the brain summarizing the physical and chemical interactions within the brain at the time of the test

Answer 28

Electroencephalography

Question 29

what is the normal ICP

Answer 29

5-15 mmHG

Question 30

if ICP is higher than ___ mmHG, it needs treatment

Answer 30

20

Question 31

therapeutic management for ICP

Answer 31

-Actions such as coughing, vomiting, and sneezing increase the ICP and should be kept to a minimum, if possible. -When burping infants after feedings, do not put pressure on the jugular veins, because this can increase the ICP. -Monitor the rate of IV fluid administration in such children, because over-hydration also can increase ICP. -Placing a child in a semi-Fowler’s position (use an infant seat for babies) can reduce cerebral pressure. -A corticosteroid such as dexamethasone (Decadron) may effectively reduce cerebral edema and its accompanying pressure

Question 32

a congenital port-wine birthmark on the skin of the upper part of the face that extends inward to the meninges and choroid plexus. Because the defect is usually unilateral, the port-wine stain ends abruptly at the midline.

Answer 32

Sturge-Weber syndrome

Question 33

is the unexplained development of subcutaneous tumors. The disorder can occur as a mutation, or it can be inherited as an autosomal dominant trait carried on the long arm of chromosome 17.

Answer 33

Neurofibromatosis (von Recklinghausen’s Disease

Question 34

hallmark symptom for neurofibromatosis

Answer 34

café-au-lait (“coffee with cream”) spots

Question 35

types of cerebral palsy

Answer 35

-Pyramidal or spastic type -Extrapyramidal or dyskinetic type -Ataxic type -Mixed type

Question 36

group of non-progressive disorders of upper motor neuron impairment that result in motor dysfunction.

Answer 36

Cerebral Palsy

Question 37

type of CP involves excessive tone in the voluntary muscles that results in loss of upper motor neurons.

Answer 37

spastic type

Question 38

type of CP involves abnormal involuntary movement. Means “wormlike.” Early in life, the child is limp and flaccid.

Answer 38

Dyskinetic or Athetoid Type

Question 39

type of CP involving having an awkward, wide based gait

Answer 39

Ataxic Type

Question 40

inflammation of brain tissue and, possibly, the meninges as well.

Answer 40

Encephalitis

Question 41

Treatment for a child with encephalitis is primarily _________

Answer 41

supportive

Question 42

acute encephalopathy with accompanying fatty infiltration of the liver, heart, lungs, pancreas, and skeletal muscle. It occurs in children

Answer 42

Reye’s syndrome

Question 43

Therapeutic Management for Reye’s syndrome

Answer 43

Therapy is directed toward supporting respiratory function, controlling hypoglycemia, and reducing brain edema

Question 44

a perplexing syndrome that involves both motor and sensory portions of peripheral nerves.

Answer 44

Guillain-Barré syndrome

Question 45

Therapeutic Management for Guillain-Barré syndrome

Answer 45

-course of prednisone to halt the autoimmune response -plasmapheresis or transfusion of immune serum globulin may shorten the course of the illness -preventing effects of extreme immobility -indwelling urinary catheter to monitor urine output

Question 46

occurs when spores of Clostridium botulinum colonize and produce toxins in the intestine

Answer 46

Botulism

Question 47

Therapeutic Management for botulism

Answer 47

antitoxin for botulism may be administered but also omitted because it is made from a horse serum base, can cause a hypersensitivity reaction, and is usually not necessary for full recovery

Question 48

Vary greatly in extent and symptoms and tend to be a difficult type to control. Often begins with a sudden change in posture, such as an arm dropping suddenly to the side, and automatisms

Answer 48

Complex Partial Seizures

Question 49

Originate from specific brain area. Begins in the fingers and spreads to the wrist, arm, and face in a clonic contraction

Answer 49

Partial (Focal) Seizures

Question 50

Type of generalized seizures. Can be controlled by: ethosuximide, valproate or off label lamitrigine

Answer 50

Absence Seizures

Question 51

3 stages of tonic-clonic seizures

Answer 51

Three stages: prodromal period, tonic-clonic stage, and postictal stage

Question 52

consist of drowsiness, dizziness, malaise, lack of coordination, or tension what stage of tonic-clonic seizure

Answer 52

Prodromal

Question 53

All muscles of the body contract, extremities stiffen, air is pushed through the glottis from contraction of the chest muscles to produce a guttural cry, and the child falls to the ground. Lasts only about 20 seconds what stage of tonic-clonic seizure

Answer 53

tonic stage

Question 54

muscles of the body rapidly contract and relax, producing quick, jerky motions. Lasts 20-30 sec what stage of tonic-clonic seizure

Answer 54

clonic stage

Question 55

vImmediately after the injury, the child experiences a spinal shock syndrome or loss of autonomic nervous system function. Lasts 1-6 weeks which recovery phase

Answer 55

first

Question 56

Flaccid paralysis of the shock phase is replaced by spastic paralysis, caused by loss of upper level control or transmission of meaningful innervation to the anterior horn which recovery phase

Answer 56

second

Question 57

Permanent limitation of motor and sensory function. If compression of spinal cord was only caused by edema and it was relieved, no permanent disability occurs which recovery phase

Answer 57

third

Question 58

A 3-year-old has just been admitted to the hospital with bacterial meningitis. Which may make the child the most afraid? A. Masks worn by the staff B. Headache C. Intravenous line in his hand D. Keeping the room lights dim

Answer 58

A. Masks worn by the staff

Question 59

When asking health history questions about the child admitted with Reye syndrome, which would be considered a common finding? A. Parental administration of acetaminophen for fever B. Recent streptococcal infection C. Recent sickle-cell crisis D. Recent influenza illness

Answer 59

D. Recent influenza illness

Question 60

A 12-year-old experiences absence seizures. Which of the following is a typical manifestation of this type of seizure? A. Rapid blinking for 10 seconds B. Spastic stiffening of all muscles C. “Marching” spasms of the left or right arm D. Stupor from which it is difficult to be roused

Answer 60

A. Rapid blinking for 10 seconds

Question 61

An adolescent has migraine headaches. Which drug would the nurse expect to be prescribed for him? A. Ergotamine tartrate (Cafergot) B. Parathyroid hormone C. Methotrexate D. Clindamycin (Cleocin)

Answer 61

A. Ergotamine tartrate (Cafergot)