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84 Cards in this Set

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  • Back
What are the three most common causes of cerebral depression?
infection, trauma, hypoxemia
What is nursing care for unconscious child?
monitor airway, monitor LOC, monitor v/s, bladder and bowel function, reflexes, protect from seizure activity
What is the function of CSF?
supplies nutrients and removes wastes products; absorbs shock of the central nervous system
What is ICP?
intracranial pressure (pressure of ICP)
If ICP is increased what happens to CPP?
decreases
What is the normal ICP for an infant?
2-6mm
What is the normal ICP for a child?
3-7mm
What is the normal ICP for older children?
0-10mm
What are some causes of increased ICP?
brain mass/volume, bruising in brain, brain tumor, subdural hematoma, abscess, hypertensive encephalopathy
What is nursing care for increased ICP in child?
close monitoring, monitor airway, monitor v/s, IV fluids, seizure protection, medications (Mannitol, Barbituates)
What are some causes of seizure disorder?
head injury, hypoxia, infection, tumor
What is nursing care number 1 goal?
airway management
What are some common medications for seizures?
Tegretol, Dilantin (5mg/kg), Phenobarbital for status epilepticus, Fosphenytoin, Ativan (based on child's weight), Ativan is not given to neonates
What are some causes of bacterial (septic) meningitis?
streptococcus pneumonia neisseria meningitis, E. coli, haemophilus influenza B
What are the s/s of meningitis?
lethargy, malaise, irritability, vomiting, petechial rash
What are the assessment tools for meningitis?
Kernig's sign, Brudzinski's sign
How is meningitis diagnosed?
CBC, DIC panel, blood cultures, lumbar puncture (hallmark)
What is the treatment for meningitis?
seizure precautions, NPO, decrease stimulation, antibiotics
In Reye's syndrome, most damage is done to the ___ and ___.
brain and liver
What does brain damage mean?
increased ICP
How is Reye's syndrome diagnosed?
from an associated viral infection, such as chicken pox, influenza, from aspirin use
What is nursing care for Reye's syndrome?
assessment of LOC, IV fluids with glucose, corticosteroids, diuretics, arterial line, oxygenation, emotional support
This is an autoimmune disease that is very rare in children?
Guillain-Barre syndrome
GBS destroys ___ ___.
myelin sheath
This is the most frequent and disabling birth defect?
spina bifida
What is the least severe spina bifida?
spina bifida occulta; local defect of the vertebral arch; no spinal cord or meningeal involvement
This is the most severe spina bifida?
Mylomeningocele; meninges protrude through defect that contain spinal cord elements, no neurological function below defect
What is the best position for spina bifida patient?
prone
For spina bifida, _____ function should be assessed to check for contractures, club feet.
orthopedic
Hydrocephalus is increased ____ production.
CSF
Most causes of hydrocephalus are _____.
obstructive (tumors, malformations, cerebral edema)
How is hydrocephalus diagnosed?
in utero, cat scan, head circumference
What is the most common permanent physical disability of childhood?
cerebral palsy
What are the different aspects of cerebral palsy?
spastic, ataxic, dyskinetic, mixed
This aspect of cerebral results in stiff muscles, poor control of posture.
spastic
This aspect of cerebral palsy causes problems with balance.
Ataxic
What are some skeletal muscle relaxants for the treatment of cerebral palsy?
Baclofen, Dantrium, botox, Diazepam, dilantin
What medications are administered for increased ICP?
Mannitol, Barbituates
Which medication given for seizures is based on the child's weight?
Ativan
What are the types of meningitis?
septic, aseptic (viral)
What is the hallmark diagnosis for meningitis?
lumbar puncture
What type of cells are injured with GBS?
Schwann cells
Reye's syndrome is diagnosed from an associated viral infection such as?
chicken pox, influenza
GBS can happen post ___ or ___ illness.
gastrointestinal or respiratory
Spina bifida is linked to ___ ___ deficiency.
folic acid
This is the most frequent and most disabling birth defect.
Spina bifida
What is meningocele?
protruding sac on the vertebra
What is Mylomeningocele?
most severe form of spina bifida in which the meninges protrude through defect that contain spinal cord elements
For spina bifida, the ___ the defect the ___ the condition.
higher, worse
What position should patients with spina bifida be placed in?
prone to prevent pressure on the sac
What type of shunts can be used for hydrocephalus?
VA or VP
What are shunt complications?
infection, overdrainage, abdominal complications, shunt malfunction
What should be assessed in a patient with cerebral palsy?
feeding ability
What is Cushing's triad?
bradycardia, irregular respirations, widened pulse pressure
What can cause Cushing's triad?
increased ICP
What is the maximum ICP for older adults that is still considered within normal limits?
20
What is the range for CPP?
50-70
An ICP >20 causes risk for?
mortality
For increased ICP, administer medications to decrease ___ __.
cerebral edema
What is Cushing's triad?
bradycardia, irregular respirations, widened pulse pressure
What is Mannitol?
osmotic diuretic; treats cerebral edema
What can cause Cushing's triad?
increased ICP
What do barbituates do?
vasoconstriction
What is the maximum ICP for older adults that is still considered within normal limits?
20
Which type of positioning represents higher functioning?
decorticate
What is the range for CPP?
50-70
Which type of meningitis is worse?
bacterial
An ICP >20 causes risk for?
mortality
For increased ICP, administer medications to decrease ___ __.
cerebral edema
What is Mannitol?
osmotic diuretic; treats cerebral edema
What do barbituates do?
vasoconstriction
Which type of positioning represents higher functioning?
decorticate
Which type of meningitis is worse?
bacterial
What is meningitis typically caused by?
streptococcus pneumoniae, E. coli, Influenza B
What is the big thing with meningitis?
petechial rash
What is Kernig's sign?
kid is lying supine, hips flexed, lower leg extension with pain
What is Brudzinki's sign?
nuchal rigidity test (head to chest)
When does the anterior fontanel close?
12-18 months
What are the big signs of meningitis in children
fever, nuchal rigidity, bulging fontanel
What is GBS?
ascending muscle paralysis disorder; can cause weak leg muscles
What are the three phases?
acute, secondary, recovery
What type of spina bifida is the most common disabling birth defect?
spina bifida occulta
Patients with spina bifida have a higher risk for?
meningitis, hydrocephalus, clubfoot
What is the most common type of cerebral palsy?
spastic