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20 Cards in this Set
- Front
- Back
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head injury-two types
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open- injury where theres a fracture of the skull, or penetration by object
closed-head injury result of blunt trauma |
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increases ICP(intracranial pressure) s/s, early signs (SSHVD CN)
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early signs
Slight change in vital signs Sunsetting eyes(sclera is visible above iris) Headache Visual disturbances;diplopiai Dizziness,vertigo Change in pupillary response and equality Nausea and vomiting |
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increased ICP(intracranial pressure) s/s late signs
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significant decrease in LOC
bradycardia decorticate posturing(abduction of arms to chest, wrist and hands flexed, Lower extrem, extended and abducted) decerebrate posturing(rigid ext. of arms and legs. fixed dilated pupils. |
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increased ICP- intervention
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1.Mon. decreased responsiveness to pain.
2.initiate seizure precautions 3. Elevate HOB 15-30 degrees if not CI 4. position head midline 5. avoid suctioning through the nares |
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ICP (signs of brain involvement)
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deep rapid, or intermittent and gasping respirations.
2. wide fluctuations or noticeable slowing or the pulse 3. widening the pulse pressure or extreme fluctuations in BP |
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hydrocephalus-description
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imbalance of CSF absorption and production caused by malformations, tumors, hemorrhages, infections and trauma.
-Results in head enlargement and ICP |
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types of hydrocephalus
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communicating- hydrocephalus occurs as a result of impaired absorption within the subarachnoid space. Interference of the CSF within the ventricular system does not occur.
noncommunicating- the obstruction of CSF flow within the ventricular system occurs. |
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hydrocephalus- interventions
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1. increased head circumference
2. thin,widely separated bones of the head that produce a cracked -pot sound(macewens sign) on percussion 3. anterior fontanel is tense, bulging, nonpulsating 4. dilated scalp veins 5. frontal bossing 6. sunsetting eyes |
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types of spina bifida-types
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1.spina bifida occulta
2. spina bifida cystica 3. meningocele 4. myelomeningocele |
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what is spina bifida occulta?
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1. vertebral arches fail to close in lumbral sacral.
2. spinal cord remains INTACT usually NOT visible. 3. Neurological deficits are NOT usually present |
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what is spina bifida cystica?
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1. protrusion if the spinal cord and/or meninges
2. incomplete closure of vertebral and neural tubes,saclike protusion in the lumbar/sacral area, varying degrees of nervous tissue involvement. 3. defect CAN include meningocele, lipomeningocele, lipomeningmyelocele |
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what is meningocele?
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protrusion involves meninges and saclike cyst that contains CSF in the midline of back, lumbosacral area
2. spinal cord NOT involved 3. neurological defects usually NOT present |
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what is myelomeningocele?
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1.protrusion of the meninges, CSF, nerve roots, and a portion of spinal cords
2. the sac(defect) is covered by a thin membrane that is prone to leakage, rupture 3. neurological deficits are evident |
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spina bifida- s/s
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1. depends on spinal cord involvement.
2. visible spinal defect 3. flaccid paralysis of the legs 4. altered bowel and bladder function 5. hip and joint deformities 6. hydrocephalus |
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spina bifida- interventions
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1. protect sac w sterile, moist(NS), non adherent dressing to maintain moisture, q 2-4 hours
2. place child in prone position |
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reyes syndrome- description
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an acute encephalopathy that follow a viral illness and that is characterized pathologically by cerebral edema and fatty changes in the liver.
cause is not clear. |
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reyes syndrome intervention
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1. aspirin is not recommended for children with varicella or influenza.
2. tylenol is med of choice 3. goal of tx is maintain effective cerebral perfusion and control ICP |
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how to diagnosis bacterial meningitis?
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testing CSF obtained by lumbar puncture. Fluid of child w meningitis is cloudy w increased pressure, increased WBC, ^ protein, DECREASED GLUCOSE
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what is Kernigs sign?
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the inability to extend the leg when the thigh is flexed anteriorly at the hip
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what is Brudzinki's sign?
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neck flexion causes abduction and flexion movements of the lower extremities
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