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50 Cards in this Set
- Front
- Back
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Inracranial Hemorrhage
etiology |
-born with brain abcesses
-hydrocephalus -difficult birth |
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Intracranial Hemorrhage
Manifestations (depends on location) |
-irregular respirations
-irritable/listless -not eating -poor suck reflex -unequal pupils -convulsions Classic-projectile vomiting - high shrill cry -bulging fontanels |
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Intracranial Hemorrhage
DX |
-observe
-look at symptoms -CT -spinal tap (sometimes) |
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Intracranial Hemorrhage
Treatment |
-can relsove on own, if small (phagocytosis takes over & resolves)
-aspirate blood to remove |
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Intracranial Hemorrhage
Complication |
if not caught early = permanent injury or die
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Intracranial Hemorrhage
Nursing Considerations |
-incubator/warmth
-head up (gravity keeps edema down) -extra vit.K (they don't produce enough at birth) -sedate to control tremors -no crying, keep quiet -snug,quite, darkness, nonstimulated enviro. |
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Fractures of infant at birth
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-clavicle/collarbone from birth canal, realign, heal quickly
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Facial Paralysis
Temp/Perm Etiology |
-Nerve injury from birth canal, pressure put on a nerve
-use of forceps |
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Facial Paralysis
Manifestations |
-droopiness - depends on what nerve
-usually one sided -can resolve self or permanent |
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Erb's Palsy
(usually not permanent) Etiology |
Injury to brachial
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Erb's Palsy
Manifestations & Tx |
-limp arm
-immobilize arm |
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Hydrocephalus is
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-abnormal amount of CSF in the cranium causing enlargement of the immature skull
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Hydrocephalus
Etiology |
-blockage of circulation of CSF
-often congenital structural defect -tumor |
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Hydrocephalus
Manifestations of ICP |
-unequal pupils
-dec. pulse - inc. BP -convulsions - tremors -enlarged head size -bulging fontanels -scalp vein distention -irritable - projectile vomiting |
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Hydrocephalus
Treatment |
-proper positioning of head
-need to dec. size of ventricles -shunt |
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Shunt
Post-op care |
-p anesthesia, nursing/bottle feed
-head circumference checks -eval. fontanels for less tense -look for changes in behavior -support head |
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Complications of post-op Shunt
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-infection
-obstruction |
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Hydrocephalus
Complications |
-mental retardation
-perm. damage from ICP -may frequent seizures -difficulty regulating temp. w/in hours |
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Care of
Hydrocephalus |
-prevent pressure on head/scalp
-support head when feeding/always -prevent malnutrition |
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Cranial Stenosis is
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Where sutures (bones join) close perm. causing inc. ICP
Can surgically re-open |
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Anencephaly is
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-born w/out brain
-die w/in hours of birth w/out life support -can detect in utero -other organs are viable |
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Mental Retardation
affects- due to- prevented with- |
affects-2% of general population
due to-birth injury (anoxia,trauma) prevented with-good nutrition, hormonal therapy, genetic counseling |
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IQ classifications may be
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affected by motivation of the child and/or the environment at the time of testing
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Profound Retardation
Severe Retardation Moderate Retardation Dull Normal Average Above Average Gifted Genius |
Profound Retardation 0-24
Severe Retardation 25-50 Moderate Retardation 51-78 Dull Normal 79-89 Average 90-110 Above Average 111-130 Gifted 131-150 Genius >150 |
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Down's Syndrome
AKA - Trisomy 21, Mongolism |
-occurs in 1 of 650 live births
-causes mild to moderate retardation |
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Down's Syndrome
Etiology |
-abnormal # of chromosomes at position 21
-has 3 (tri) chromosomes |
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Down's Syndrome
Manifestations |
short stature, smaller skull, flattened appearance, large tongue, low birth wt, lethargic @ birth, eyes slant up & out, short hands/fingers, little finger bends inward, crease across middle of hands, large space big toe/little toes, small white dots on iris, dec. muscle tone=inc. joint mobility
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Down's Syndrome
Effects on Growth & Development |
-delay in eruption of teeth
-fissured tongue (crease in center) -retarded intelligence -slow physical development -inc. risk for congenital heart defects -placid/bland & loving -life span mid 40's |
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Down's Syndrome
Tx |
Supportive
-can test amniotic fluid = may terminate pregnancy -where to educate home/school |
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Phenylketonuria
PKU |
a type of mental retardation less common than Down's Syndrome
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PKU
Etiology |
-body born w/out the enzyme to breakdown essential aminoacid
-can cause brain damage |
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PKU
Evaluation |
PKU test done at birth
mandated test w/in 72 hours |
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PKU
TX |
-dietary measures
-eliminate affending protein indefinitely -aggressive tx to prevent retardation |
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Galactosemia is
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a metabolic error; may produce physical and mental retardation, cataracts, enlarged liver and/or spleen, cirrhosis
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Galactosemia
Etiology |
body's ability to metabolize galactose to glucose
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Galactosemia
Manifestations |
-babies vomit
-FTT=failure to thrive (babies not gaining wt) 1-2 weeks before seeing this |
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Galactosemia
TX |
-milk substitutes
-may start some dairy around schoolage |
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Congenital Hypothyroidism
(AKA Cretinism) |
delayed treatment produces irreversible mental retardation and eventual growth retardation
mandated by law to test at birth |
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Congenital Hypothyroidism
Manifestations & Dx |
-large tongue & abdomen
-hoarse cry -coarse hair -dry skin -initially constipation dx-T4, TSH |
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Spina Bifada is
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"divided spine"-a portion of the posterior spine is missing; may be detected in utero by analysis of maternal serum & amniotic fluid (US may detect)
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Spina Bifada Occulta
pic B |
-missing portion of spine only
-spine safely in canal -found by xray -indentation where spine missing -small patch/tuft of hair -not considered major disability |
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Spina Bifada Cystica
Meningocele pic C |
-protrusion only of spinal fluid
-bulge -no deformities of spine |
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Spina Bifada Cystica
Myelomeningocele pic D |
-meninges/sac contains part of spine
-causes neurological damage -can cause weakness & paralysis |
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Spina Bifada Cystica
C & D Nursing Care |
-protect area until surgery
-use pillows when laying down -no pressure on sac -good neuro eval of extremeties -bowel and bladder impairment -if leak, sterile drsg, no pressure -head circumferences -could cause hydrocephalus/ICP |
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Spina Bifada Cystica
C&D misc. |
-surgery does not usually improve function, aids in care & appearance
-Some infants have clubfeet & bladder dysfunction |
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Cleft Lip
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-simple notching of the border of lip to a deep split to nose
-center ,side or both sides lip -no problems feeding on nipples -problems w/appearance -repair early (10 wks old) -may need 2nd repair later |
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Cleft lip post-op care
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-restrain elbows from bending, don't want them touching
-keep suture line clean, neosporin -no crusting of suture -start w/water progress to milk, sitting up, feed slowly -keep from cyring |
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Cleft Palate
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-lack of fusion of palate
-can be partial/complete, hard/soft palate -repair 1-1 1/2 old -can make palate prosthesis |
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Cleft Palate
Pre-op |
-meticulous feeding technique
-test swallowing w/med dropper -lamb nipple, long & puts milk to back of mouth -sit up, prevent aspiration -burp often, swallow lots of air |
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Cleft Palate
Post-op |
-drink w/cup (reason for delay surg)
-no spoons or anything in mouth until healed -may need restrain elbows -need oral surgeon, ST, pediatrician, orthodontist -inc. risk of URI (aspiration pneumonia) |
