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16 Cards in this Set

  • Front
  • Back
**When should the neural tube close?**
15-28 days post conception (failure to close will result in neural tube defects)
What is the definition of anencephaly?
both cerebral hemispheres are absent, incompatible with life
What is the most common anomaly associated with spina bifida?
hydrocephaly occurs in 80-85% or cases
How early should spina bifida be closed?
24-72 hrs after birth to decrease M&M from serious infection
Will closure of spina bifida change the physical disability?
NO!!! surgery will not change the physical disability
S&S of hydrocephalus and ICP?
Tight and bulging fontanel
Dilated scalp veins
High pitched cry
Restless
**BP goes up, HR down, RR down or irregular with increased ICP**
What must you always assume with a spina bifida baby?
NORMAL INTELLECT
What is frontal bossing?
Frontal protrusion of the ehad
Why would you never give anti-emetics to a baby with hydrocephalus?
Vomiting may be the way the body is able to decrease ICP
**What is the survival rate for hydrocephaly with surgical treatment?**
**90% survival and 2/3 are intellectually normal**
What vaccine has almost eliminated bacterial meningitis?
HIB
How is bacterial meningitis manifested?
1. abrupt onset, fever, chills, HA, vomiting, change in sensorium, irritable, agitated, photophobia, confusion, hallucinations, drowsiness, stupor, coma
2. Meningocococcal - purpuric/petechial rash (early may be just in one area-if suspect meningitis must see ALL of the client)
3. Nuchal rigidity
4. Kernig sign (positive) - assess pt. flat on back, bend and then straighten out the leg and they will feel pain in hamstring if it is positive.
5. Brudzinski sign (positive)- assess pt. flat on back, flex neck and assess reflex contractions of hips and knees.
6. Seizures in a child without a seizure disorder is the first sign.
7. Children ages 3 mo. to 2 yrs.
(bulging fontanel - MOST significant sign because it's a release for increased ICP; fever; poor feeding; vomit irritable; restless; high pitched cry "neuro cry")
7. Nuchal rigidity, Brudzinski, Kernig - not consistently present in young child less than 18 months
8. Neonates - difficult to diagnose, vague like all neonatal sepsis. They PRESENT with the sign of poor feeding. They also have poor suck, poor muscle tone, hypothermia/fever, resp irreg, apnea, weight loss, irritable, drowsy, bulging fontanel (may or may not appear), neck is usually supple so you will not be looking for rigidity.
Why might bacterial meningitis result in obstructive hydrocephalus?
pus is occluding the passages
**What population has the highest M&M from bacterial meningitis?**
Children under 4 years of age
What must you assume if a baby under 6-8 weeks of age presents with a fever?
Since a baby does not have much of an immune system, you must assume they have the worst infection possible
What adverse effect is associated with many of the antimicrobials used in bacterial meningitis?
ototoxicity