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Critical Care Pediatics > Peds Neuro > Flashcards

Peds Neuro Flashcards

(69 cards)

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1
Q

drowning

A

only takes enough water to cover nose and mouth

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2
Q

near drowning / submersion injury

A

aspirated water damaging lung surfactant causing lung damage

**leads to hypoxia

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3
Q

drowning physical concern

A

hypoxia –> anoxia –> cerebral edema –> concern

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4
Q

what happens when drowning…

A

panic –> sporadic motion –> aspiration –> laryngospasm –> hypoxia

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5
Q

laryngospasms

A

causes bronchoconstriction limiting further aspiration

**when pulled out earlier it causes less fluid overload

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6
Q

hypothermia

A

occurs faster in water than in air , need to know the amount of time in the water

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7
Q

hypothermia s/s

A

depend on temp of water
length of time submerged
initial scene treatment

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8
Q

what to do when finding drowning victim on scene…

A

immediate CPR w/o pulse or breathing

**those in water for only 5-10 min have a better prognosis

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9
Q

what to do for drowning victim in hospital….

A
  1. airway
  2. HYPERoxygenation
  3. rewarming
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10
Q

passive external rewarming

A

take off wet clothes
blankets
increase room temp

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11
Q

active external rewarming

A

warm blanket
heating pads
radiant heat
warm bath
forced warm air

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12
Q

active internal warming

A

endovascular rewarming
peritoneal / pleural irrigation

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13
Q

drowning prevention education

A

constant observation - includes bathtime
fencing, pool alarm, floaties
ripcurrents
adult drinking @ beach / pool
swim lessons

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14
Q

normal intracranial pressure

A

15-20 mmHg

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15
Q

early increased intracranial pressure s/s

A

poor feeding
vomiting
irritability
lethargy
headache
sunsetting eyes!!
visual disturbance
dizziness / vertigo

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16
Q

IICP in infants

A

irritability
bulging fontanelle!!
wide sutures
dilated scalp veins
high pitch cry

**has early signs PLUS this

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17
Q

IICP late signs

A

significant decrease in LOC
seizures
fixed / dilated pupils, papilledema
cushing’s triad

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18
Q

cushing’s triad

A

increased systolic BP and wide pulse pressure
bradycardia
irregular respirations

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19
Q

IICP traumatic

A

MVA
GSW
anoxia
abuse : causing swelling and bleeding - shaking baby

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20
Q

IICP autonomic

A

hydrocephalus
tumors
infection
seizures
hypoxia

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21
Q

avoid these with IICP…

A

lumbar punctures may lead to herniation

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22
Q

hydrocephalus / IICP tx

A

VP shunt : drains excess CSF to belly
-monitor ICP, pain level, LOC, behavior, vitals

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23
Q

hydrocephalus shunt education

A

infection
failure
malfunction
DO NOT press on shunt post op
sutures come out follow up appointment

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24
Q

VP shunt failure s/s

A

rapid onset of vomiting
severe headache
irritability
lethargy
HA
seizures
bloating

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25
over-draining s/s
nausea, dizziness, HA
26
Spinal cord injuries
-complete vs incomplete -compression / shearing -inflammation cause
27
complete spinal cord injury
irreversible loss of all sensory, motor, autonomic fxn below level of injury
28
incomplete spinal cord injury
varying degree of sensory, motor, autonomic fxn below level of injury
29
compression injury
loss of reflexes or movement
30
inflammation causes
ischemia in area --> necrosis
31
number one cause of peds spinal injuries...
MVC accidents -not wearing seatbelts -wrong car seat size
32
spinal cord complications
-impaired respirations : diaphragm paralysis -autonomic dysreflexia -scoliosis -DVT -pressure ulcer -hip instability!!!
33
autonomic dysreflexia
increased BP flushed face HA distended neck veins decrease HR sweating
34
why does autonomic dysreflexia typically occur...
distended bladder constipation pressure ulcer **tx includes fixing the cause
35
spinal cord nursing care
1. airway : O2, trach, intubate 2. nutrition : TPN, G-tube, NG tube 3. bowel / bladder : stool softener, straight cath, routine 4. skin : early ambulation, repositioning 5. promote independence
36
cerebral palsy
1. congenital = brain damage before birth 2. acquired = brain damage after birth **muscle growth is limited d/t spasticity affecting bone growth, has varying degrees of contractures
37
spastic CP
difficulty moving just one side, just legs, or all limbs **most common
38
athetoid CP
difficulty controlling movements
39
ataxic CP
problems with balance / coordination
40
mixed CP
can include any or all of the types of CP
41
congenital CP risks
1. maternal infections 2. placental abnormalities 3. multiples 4. LBW 5. asphyxia at birth 6. meconium aspiration
42
acquired CP risks
1. bacterial meningitis 2. severe jaundice 3. anoxic injury after brith
43
CP development...
delayed in physical development -sitting -rolling -walking -speech -crawling
44
CP clinical care
supportive therapies -sustain fxn of where they are -airway support - cannot expand diaphragm well -nutrition - feed however we can
45
muscular dystrophy
muscular weakness and decrease in muscle tone overtime **progressive degeneration of skeletal muscle
46
becker MD
around age 12 -progressive weakness in pelvis and legs
47
fascioscapulohumeral MD
weakness of shoulders and face muscles -LEAST debilitating -occurs later in life
48
duchenne MD
most rapid form -dx before 6 yrs -death in 20s d/t cardiac or resp failure
49
duchenne MD patho
passed from mother --> male -lack of dystrophin (muscle protein) -Gower's sign
50
Gower's sign
child uses hands to push on legs and stand
51
dystrophin
muscle protein located on skeletal muscle and X chromosome, when we don't have enough = muscle deconstruction
52
osteogenesis imperfecta
"brittle bone disease" -genetic defect in collagen produced in bones
53
osteogenesis imperfecta s/s
-multiple frequent fractures -blue sclera!! -short stature -thin, soft skin -weak muscles -altered joint flexibility -delayed walking
54
osteogenesis imperfecta dx
US - dx in utero DEXA- bone density scan X-rays **can be mistaken for abuse with multiple fracture hx
55
osteogenesis imperfecta care
maximize independence maximize mobility minimize fractures
56
osteogenesis imperfecta diet
needs to be high in vitamin C, D, calcium
57
surgical stabilization osteogenesis imperfecta
used to prevent bowing of legs during growth
58
what is something to think about for BP and osteogenesis imperfecta...
take them manually!! **prevents overinflation of cuff and breaking of bones
59
juvenile arthritis
begins as early as 2 yrs genetic **ankle, knees, hips affected **typically bilateral pain
60
juvenile arthritis labs
CBC rheumatoid panels CRP - inflammation indicator
61
juvenile arthritis care
pain control -aleve, naproxen, methotrexate nutrition uveitis - inflammation of iris delayed puberty
62
child abuse risks
1. young parents 2. domestic violence 3. parental mental health 4. substance abuse 5. families w/ premature or chronically ill pts 6. ODD / ADHD parents 7. sexual abuse from parental figure
63
unintentional abuse
could be from lack of education ex : neglect
64
intentional abuse
physical abuse, typically seen to late, sexual abuse **strong alliance to abuser
65
physical abuse s/s
-accident prone -inconsistency w/ story -redirecting blame on sibling / visitor -delay in seeking medical tx -uncommon injury sites -hypervigilance
66
sexual abuse
-genital complaints -difficulty walking / sitting -stained clothing -inappropriate sexual behavior -excessive / public masturbation -drawing sexual actions
67
most common fracture in physical abuse
spiral fracture of femur = twisting motion **every spiral fracture needs to be looked at as abuse
68
non-specific behaviors
change in appetite, demeanor, mood, sleep are common
69
neglect behaviors
-poor hygiene -clothes do not match weather -developmental lag -hunger and fatigue -unattended medical needs

Critical Care Pediatics (4 decks)

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