Neuro 3 Flashcards
(27 cards)
describe spina bifida occulta
- mild
- posterior vertebral arches fail to fuse
- NO herniation of spinal cord or meninges
- NO loss of function
- may have dimple or hair duft
describe meningocele
- mild
- no herniation of spinal cord or meninges
- no loss of function
- *sac is repaired in first 48 hrs of life
describe myelomeningocele
- concerning
- posterior vertebral arches fail to fuse and SACLIKE herniation contains meninges, CSF, and portion of spinal cord or nerve roots
- surgery to repair within 24-48 hrs of birth
- neurologic bladder or bowel
- motor impairment of lower body
- risk for latex allergy d/t surgery
spina bifida pre op care
- position on side/abdomen
- keep sac moist with sterile, saline soaked dressing
- avoid contamination of sac by urine/feces
- encourage parent bonding
spina bifida post op care
- assess neuro status (no lower motor control)
- monitor I&Os
- monitor incision site
- discharge education
describe cerebral palsy
- early onset of impaired movement and posture
- usually nonprogressive
- other problems:perceptual, language deficit, and intellectual impairment
- can be spastic type
causes of cerebral palsy
- anoxia (birth asphyxia)
- prenatal brain abnormalities
- premature birth
cerebral palsy is characterized by
- most common permanent physical disability of children
- characterized by abnormal muscle tone and coordination
nursing care of cerebral palsy
- adequate nutrition
- maintain skin integrity
- promote physical mobility
- promote safety
- promote growth and development
- teach parental care
describe spastic cerebral palsy
- most common form
- abnormal muscle tone
- hypertonic, poor postural control, balance and coordination
- gross and fine motor skills are impaired
what is TBI
Defined as any trauma to the head that causes a change in level of consciousness or an anatomic abnormality of the brain – disrupts normal brain functioning
describe TBI
- Leading cause of death and disability among children
- May be cause by blunt force (head struck by an object, shaking) or penetrating (bullet) mechanisms
- When an injury occurs the impact transfers energy through the skull and meninges to the brain
who is at the greatest risk for TBI
- Infants are at greater risk for skull fractures and intracranial injury because they have thinner and more pliable skulls
- Children under age of 2 have a greater risk for intracranial injury after traumatic brain event
Pathologic process involving the scalp, skull, meninges, or brain as a result of mechanical force
head injury
leading cause of death and disability in children and adolescents
TBI
manifestations of TBI
- Bruise or bump on the head / bruising over the temporal area or around the eyes
- Headache
- Bleeding from ears, nose, laceration
- Seizures
- Vomiting
- Irritability and agitation
- Loss of consciousness
- Decorticate or decerebrate posturing
primary head injuries
Scalp lacerations Concussion Cerebral contusion Skull fractures Hematoma Subarachnoid hemorrhage Diffuse axonal injury
secondary head injuries
Result from the severity of the primary brain injury:
Cerebral edema
Meningitis
diagnostic test of head injuries
Skull X-ray
CT of the brain
MRI of the brain
medical management of head injury
Goals are to prevent and minimize secondary injury to the brain
If severe injury, airway, breathing, and circulation
sections of GCS
3 major areas; eye opening, motor response, and verbal response
-highest score 15 and lowest 3 / scores of 8 or less severe injury; 9 to 12 moderate injury; and 13 to 15 minor injury
management of minor injuries
wake every 2 hours to check mental status / return to ED if vomiting, sleepiness, headaches, confusion, restlessness, personality changes, seizures, bleeding from ears or nose, inconsolable irritability occurs
management of moderate injuries
usually admitted for observation
management of severe injuries
admitted to PICU / may require surgical evacuation of subdural or epidural hematoma along with supportive management
