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