Peds Assessment: Neurodevelopmental Assessment

Front 1

If a child presents with hypertonicity, what disorder should be considered?

Back 1

CP

Front 2

At what age can CP be diagnosed?

Back 2

after age 1

Front 3

If double diplopia is found in teens, what may be a possible diagnosis?

Back 3

Tumor or MS

Front 4

List the environmental influences to nervous system development?

Back 4

-nutrition
-hormones
-O2 levels
-maternal life-style
-state of health

Front 5

What disorders associated with neural tubes can lead to dysfunctions in nervous system development?

Back 5

-Neural plate problems
-groove, folds or tube defects

Front 6

True or False: disruption in any stage of the embryonic development of the CNS can cause disorders?

Back 6

TRUE

Front 7

What are the common symptoms associated with brain tumors in children?

Back 7

Nausea and vomiting in the morning

Front 8

List the general symptoms associated with neurodevelopmental problems.

Back 8

-vision problems
-loss of hearing
-big changes in weight
-persistent nausea and vomiting
-headaches
-fainting spells and blackouts
-change in memory
-hyperactivity
-weakness in one part of the body
-clumsiness or unsteadiness
-changes in bowel or bladder habits
-

Front 9

What are the 5 important components of a neurodevelopmental history?

Back 9

1. health history
2. behavioral assessment
3. psychosocial assessment
4. school performance
5. Developmental history

Front 10

What is the most frequent neurological complaint from children?

Back 10

headaches

Front 11

Which neurologic exam looks at how your brain and nervous system affect the way you think and behave?

Back 11

Neuropsychologic evaluation

Front 12

The neurodevelopmental evaluation is the same exam as the ___ ___

Back 12

neurologic evaluation (in Rita's opinion)

Front 13

True or false: 1/2 of CP is outgrown by age 7?

Back 13

True

Front 14

When can MD present?

Back 14

in childhood or adolescents

Front 15

What is a major symptoms of MD?

Back 15

word retrieval problems.

Front 16

In terms of neurologic dysfunction, what is the most difficult of all changes that may occur in a child?

Back 16

Sensory changes: peripheral neuropathies

Front 17

ADHD must present before age ___ to be properly diagnosed?

Back 17

seven

Front 18

What gestational age group has been found to have an increase risk for ADHD? what % of these children are dx with it?

Back 18

late-preterm; 12

Front 19

True or false: early brain trauma in children is very detrimental and rarely recovers?

Back 19

FALSE! a baby has a nervous system that can change overtime! CP can be outgrown

Front 20

What are the important symptoms that a HCP would want to listen for if expressed by the parents?

Back 20

-Attention problems
-memory problems
-behavioral difficulties
-language and communication difficulties
-sleep pattern
-vision problems
-neck pain
-weakness or jerks
-gait problems
-sensory changes
-nonstop talking
-projecting of mother's problem to child
-avoiding talking about the problem

Front 21

At what age can a child begin to ride a tricycle?

Back 21

2.5

Front 22

when do children start to ride a bicycle?

Back 22

6 or 7

Front 23

Ture or false: It is normal for children to gain and lose milestones at the same time?

Back 23

FALSE! they should never lose a milestone while gaining others

Front 24

Localization of neurological disorders requires __ and further __

Back 24

referral; follow-up

Front 25

The HCP should make patient or mom define terms like; __, ___, __, ___, and __ during a neurologic exam.

Back 25

dizzy, fainted, passed out, migraine, tired.

Front 26

True or false: it is important to minimized complaints of neurological changes because they are often outgrown?

Back 26

FALSE; you do not want to minimize them! look into them

Front 27

If there is a problem with thinking or ___, then problem may be localized to the ____.

Back 27

remembering; hemispheres

Front 28

If there is a problem with coordination, the __ may be where the problem is.

Back 28

cerebellum

Front 29

What areas of the body may be affected if there is a problem with the spinal chord?

Back 29

-arms/legs
-bladder
-bowel control

Front 30

If there is a ___ problem, the left hemisphere may be involved?

Back 30

speech

Front 31

Where might a lesion be present in the brain for a child that is hyperreflexive?

Back 31

upper motor neuron lesion

Front 32

Which disease is associated with a problem at the neuromuscular junction and an overproduction of ACTH?

Back 32

myesthenia gravis

Front 33

What bodily physical features are common with MD patients?

Back 33

Big calves and thin thighs

Front 34

Describe the features associated with brain dysfunction (ie. Mental status, dysmorphic features, distribution, DTRs, and Muscle Mass)

Back 34

MS: decreased
Dysmorphic features: +
Distribution: quadriplegia
hemiplegia
Diplegia
DTR: 4+
Muscle Mass: -

Front 35

Which neurologic dysfunction can have normal DTRs?

Back 35

Neuromuscular junction

Front 36

Which neurologic disorder can have variable/cranial nerve distribution according to the chart?

Back 36

neuromuscular junction disorders

Front 37

Which neuro disease will have 0 DTR's according to the chart? What is its distribution?

Back 37

anterior horn cell disease. Proximal distribution

Front 38

The more problems that the child presents with that do not localize to one area, the more likely the problem involves ___ ___

Back 38

psychosocial realms

Front 39

What is the most important piece of history to develop an action plan for an acute head injury or an acute neurological event?

Back 39

Mechanism of action

Front 40

What is included in the episodic history for a head injury?

Back 40

get as much information as possible from people on the scene of an acute event

Front 41

list the 8 steps that must be carried out to be considered a proper neurologic exam.

Back 41

1. overall inspection of the body
2. general cerebral funciton
3. cranial nerves
4. reflexes
5. motor strength
6. sensory
7. proprioceptive and cerebellar function
8. soft signs

Front 42

Describe what is meant by a soft sign.

Back 42

anything that the child does that may see different. ie distractable,

Front 43

What is the HCP looking for in an inspection of neurocutaneous lesions?

Back 43

Hypopigmented/hyperpigmented macules of different texture. cafe au lait spots

Front 44

What are some ways to assess for muscle atrophy?

Back 44

weakness in gait; thumbs facing you when the pt is walking?

Front 45

What should be assess when looking at gait?

Back 45

assess for signs of weakness

Front 46

Tor F: a child should have handedness by 18 months of age?

Back 46

False! 2 years

Front 47

ToF: parents often are not able to tell if their children's have birthmarks?

Back 47

false! they can

Front 48

Why assess the skin in a neurodevelopmental exam?

Back 48

The skin is a dermatologic clue to underlying disease

Front 49

What is the name for white marks on the skin of children that can be illuminated with a woods lamp?

Back 49

Leaf spot

Front 50

If a child has a flat red capillary skin stain on their face, this is most likely a __ __.

Back 50

flammeus nevus: port wine stain

Front 51

Which disorder is associated with ash leaf macules?

Back 51

tuberous sclerosis

Front 52

Children with tuberous sclerosis often have a shagreen patch in the ___ area that looks like a ___ ___.

Back 52

lumbosacral; orange peel

Front 53

what are the name of the acne like lesions on the cheeks, nasolabial folds an malar area of children that have tuberous sclerosis?

Back 53

Adenofibromas

Front 54

other than the dermatologic findings, what are the symptoms of tuberous sclerosis?

Back 54

-Mental retardation
-seizures
-rough growths under or around fingernails and toes
-pitted dental enamel

Front 55

what are the findings in the eyes with patients with tuberous sclerosis>

Back 55

-retinal abnormalities
-mulberry tumor
-astrocytomas (tumor)

Front 56

Patients with tuberous sclerosis may have __ __ in the brain upon MRI, or __ __ found through CT?

Back 56

benign tumors (tubers); calcium deposits

Front 57

what are the finding in the heart as a result of tuberous sclerosis?

Back 57

abnormal heart rhythm or tumor (rhabdomyomas)

Front 58

ToF: the kidneys are not an effected organ secondary to Tuberous sclerosis?

Back 58

false: they can have benign fatty tumors, serious tumors or cysts in the kidneys

Front 59

Elephant man syndrome has been linked to which disorder that presents with skin abnormalities?

Back 59

neurofibromatosis

Front 60

In order to be diagnosed with nuerofibromatosis, a pt must have __ or more cafe au lait spots that are greater than __ mm in a child under 5 or greater than 15mm in a ___ child.

Back 60

6; 5; postpubertal

Front 61

ToF: all children with neurofibromatosis will have a rapid increase in the number of cafe au lait spots during puberty?

Back 61

TRUE

Front 62

What is an important location to examine for cafe au lait spots?

Back 62

in the axillary region

Front 63

What is a problem that can occur in the eye of children with neurofibromatosis?

Back 63

Astrocytic hamartoma of the retina: have a cut in the visual field from a tumor in the optic tract

Front 64

what is the number one disorder to assess for in a child with a port wine stain that crosses the trigeminal nerve lines?

Back 64

sturge weber

Front 65

what is the classic sign of incontinentia pigmenti?

Back 65

swirls on the butt: follow lines of blashko

Front 66

what are the follow lines of blashko?

Back 66

appear like vesicles in the legs and but and turn into hyperpigmentation

Front 67

What can sturge weber do to the eyes?

Back 67

causes glaucoma

Front 68

what is gower's sign>?

Back 68

the child has to climb up himself or use a chair to go from sitting on the floor with legs crossed position to a standing

Front 69

Large __ muscles may be indicative of muscular dystrophy especially if the child has __ __ weakness.

Back 69

calf; pelvic girdle

Front 70

an increase in a child's lumbar curve may be a sign of muscle ___

Back 70

weakness

Front 71

What physical assessment finding should be looked for when assessing for marie charcot tooth?

Back 71

thin, stork like legs

Front 72

In MCT, neuropathy will present with __ weakness and therefore __, ___ like legs is a sign of __ nerve disease.

Back 72

distal; wasting; stork; peroneal

Front 73

___ usually present with central weakness.

Back 73

myopathies: have a weak pelvic girdle

Front 74

Neuropathy will present with ___ weakness.

Back 74

distal

Front 75

What should the HCP watch for in the hands and the tongue of MCT?

Back 75

tremors when the hands are moving and in the tongue when NOT crying

Front 76

What disorder is associated with claw feet and a high arch?

Back 76

diastematomyelia: spinal cord is stuck

Front 77

True or F: a complete neurological exam in children must be modified due to developing nervous system?

Back 77

true

Front 78

To test cerebral function, you must do a ____ exam

Back 78

neurodevelopmental

Front 79

___ affect or lack of ___ may indicate an underlying depression

Back 79

flat; expression

Front 80

What must be done with a child in special education during a cerebral examination?

Back 80

the questions must be adjusted to child development

Front 81

what is the acronym for testing cerebral function?

Back 81

JOMAC

Front 82

What does JOMAC mean?

Back 82

J-Judgement, problem solving
O-Orientation to time and space
M-Memory
A- Affective disturbances
C- Calculation disturbances

Front 83

what age is appropriate to use JOMAC?

Back 83

>3

Front 84

What are the major findings that the nurse should observe for when assessing cerebral function?

Back 84

-hyperactivity
-decreased attention span
-distractibility
-disinhibition
-emtional liability
-impulsivity
-hypoactivity
-lack of spontaneity
-low frustration level, self esteem

Front 85

At what age can a child kick ball forward

Back 85

2

Front 86

when should a child be able to combine 2 words

Back 86

2

Front 87

A child of 2 should be able to build a tower of __ blocks

Back 87

7

Front 88

what are 3 major neuro developmental milestones for a 2 year old?

Back 88

-kick ball forward
-removes article of clothing (not hat)
-combines 2 words

Front 89

A child of __ should be able to throw a ball overhead, name 4 animal pictures, pedal tricycle and put on clothing?

Back 89

3-5

Front 90

What are 5 neurodevelopmental milestones of 4 year olds

Back 90

-plays games with other children
-says what to do when tired, cold, hungry
-says first and last name when asked
-copies a circle
-balances on each foot for 2 seconds

Front 91

What are the 5 milestones of a 5 year old?

Back 91

1. dresses without supervision
2. copies a cross
3. draws a person
4. puts objects on, under, infront of and behind when asked
5. hops on one foot 2 or more times

Front 92

What are 3 major milestones of a first grader?

Back 92

1. draws a person-6parts
2. copies a squar
3. Heel to toe walk!!

Front 93

What is the medical term for lack of smell

Back 93

anosomia

Front 94

At what age can children truly begin to accommodate with their pupils?

Back 94

6-7

Front 95

Can you say cranial nerves 1-12 intact on a very young child?

Back 95

NO: they cannot tell you if they smell

Front 96

What must be visualized in the eye to say that cranial nerve 2 is intact?

Back 96

the optic disc

Front 97

Which syndrome is associated with an inability to produce sweat on one side of the face, ptosis and a lack of pupilary reaciton?

Back 97

Horner's syndrome

Front 98

When do children often present with horner's syndrome

Back 98

post cardiac surgery

Front 99

What does a normal eye look like when looking in the opthalamascope?

Back 99

sharp beautiful sun with vessels that clearly combine at the center

Front 100

What does a C shaped halow around the optic disc often indicate?

Back 100

early sign of papilledema and often have blurring in the middle of the vessels

Front 101

What is the grade of papilledema when an edematous halo surrounds the optic disc?

Back 101

grade 2

Front 102

When the edema of papilledema covers major blood vessels as they leave the optic disk and vessels on the disk, what is the appropriate grade?

Back 102

4

Front 103

What disorder is often associated with nystagmus?

Back 103

albinism

Front 104

What deficiency can lead to albinism?

Back 104

tyrosine

Front 105

Horiztonal nystagmus may be seen with ___, ___, or ___ pathology

Back 105

labyrinthine, cerebellar or brainstem

Front 106

___ nystagmus my be from cerebellar or brainstem pathology

Back 106

vertical

Front 107

Which medication toxicity can lead to horizontal or vertical nystagmus?

Back 107

Dilatin

Front 108

What is the most common kind of nystagmus in children?

Back 108

end point

Front 109

How should cranial nerve 5 be assess?

Back 109

-inspect for muscle atrophy
-have child make "monster face," or clench jaw and feel the masseter muscle
-test for touch and temp sensation
-Corneal reflex is deferred

Front 110

How should you assess cranial nerve 7

Back 110

Smile
frown
puff out cheeks
raise eyebrows
close eyes tight

Front 111

ToF: with a central lesion, the patient can scrunch their forehead, but cannot close their eyes?

Back 111

False: they can do both

Front 112

What can a patient NOT do with a peripheral facial nerve paralysis?

Back 112

-scrunch forehead
-close eyes

Front 113

What is determined by cranial nerve 8

Back 113

hearing and equilibrium

Front 114

What is used to test the 8th cranial nerve?

Back 114

audioscope or audiometer for a routine hearing screen

Front 115

How do you assess gross hearing?

Back 115

whisper or tuning fork test

Front 116

what is the name of the hearing test where a tuning fork is place above the head midline

Back 116

weber

Front 117

if a child hears better on one side during the weber test, what kind of hearing loss will they usually have?

Back 117

sensorineural

Front 118

If a patient has unilateral conductive hearing loss, what will the result of the weber test be?

Back 118

they will hear better in the abnormal ear

Front 119

Normal air conduction is ___ as long as bone?>

Back 119

twice

Front 120

what does the rinne test show?

Back 120

bone vs air conduction

Front 121

what are 4 possible causes of conductive hearing loss

Back 121

1. eustachian tube dysfunction
2. ear fluid
3. hole in eardrum
4. fixed middle ear bone

Front 122

Noise induced hearing loss, presbycusis, menieres and tumor are all examples of ___ hearing loss

Back 122

sensorineural

Front 123

What are ways to assess for cranial nerve 9

Back 123

Glossopharyngeal:

Test the ability to swallow, gag reflex, test for sweet/sour taste

Front 124

If the nurse is looking at the rise of the soft palate and the ability of the uvula to stay midline, which cranial nerve is she assessing?

Back 124

9 and 10

Front 125

When the child is pushing their head against resistance and raising their shoulderw, which cranial nerve are they showing is in tact?

Back 125

11: the accessory

Front 126

How is the hypoglossal nerve checked?

Back 126

sticking out the tongue and moving side to side

Front 127

if a unilateral lesion is present on the 12th cranial nerve, what sign might the patient show?

Back 127

their protruding tongue will deviate towards the affected weaker side

Front 128

reflexes can be reinforced by having the patient perform ___ ___ of other muscles

Back 128

isometric contraction: jurassic maneuver

Front 129

What is the most important aspect to assess for when looking at the reflexes?

Back 129

symmetry

Front 130

what is the grading scale for DTR's

Back 130

0 - absent
1+ - hypoactive
2+ - normal
3+ - hyperactive
4+ - hyperactive with clonus

Front 131

What are the DTRs to check in the neurodevelopmental exam?

Back 131

-bicep
-tricep
-brachioradialis
-patellar
-achillis
-abdominal
-babinski
-snouting

Front 132

which vertebrae are involved in the bicep reflex>?

Back 132

C 5 and 6

Front 133

C6 and C7 are responsible for the __ reflex

Back 133

tricep

Front 134

How should the child be checked for clonus?

Back 134

support the knee in a partly flexed position

with the pt relaxed, quickly dorsiflex the foot and observe for rhythmic oscillations

Front 135

THe brachioradialis reflex is controlled by which vertebrae

Back 135

C5 and 6

Front 136

Which vertebrae are responsible for the abdominal reflex?

Back 136

T 8-12

Front 137

which direction does the umbilicus deviate to during the abdominal reflex?

Back 137

towards the stimulus

Front 138

what position must the child be in to do the abdominal reflex?

Back 138

lying down with knees bent

Front 139

L2, L3 and L4 are responsible for the __ reflex

Back 139

patellar

Front 140

What is the best position to conduct the achillis reflex?

Back 140

with the pt's knee on a chair

Front 141

what is the chaddock reflex?

Back 141

when you draw on the side of the foot and you assess the movement of the toes. POsitive if the toes move up. --> bad

Front 142

What is the oppenheimer reflex? what should occur?

Back 142

you firmly press down on the shin and run the knuckle and thumb along the anterior medial tibia. Nothing should happen. positive test if the toes fan upward

Front 143

What is the snouting relfex?

Back 143

when you tap on the philtrum (above the upper lip) and the person scrunches up their mouth. Do not want to see that

Front 144

Children cannot tandem walk forward until age ___ at the earliest but as late a __ is acceptable

Back 144

4;6

Front 145

What is one of the most important inspections in assessing motor strength

Back 145

watching the child walk

Front 146

what are the aspects of the motor function test?

Back 146

-body posture
-gait
-balance
-coordination
-gowers sign

Front 147

what are the type of tremors?

Back 147

resting, postural, intention

Front 148

what is the grade if there is no muscle strength?

Back 148

0/5

Front 149

if a pt has visible muscle movement, but not at the joint, what is their grade

Back 149

1/5

Front 150

movement at the joint, but not with gravity has a __ grade

Back 150

2/5

Front 151

what is grade 3/5 for muscle strength

Back 151

movement against gravity, but not against resistance

Front 152

if a pt can move against gravity and resistance, but less than normal what is the grading?

Back 152

4/5

Front 153

what disorder is characterized with constant muscle contraction that cannot be released unless through cog wheel movements?

Back 153

myotonic dystrophy

Front 154

is MCT disease a myotonic or neuropathy disease?>

Back 154

neuropathy

Front 155

why are boys with dechenne MS thought to be psuedohypertrophic?

Back 155

they appear to have muscly calves but in reality it is fat

Front 156

describe the motor milestones of a child with duchenne MD.

Back 156

SLOW!

18 months: start walking
2-3: somewhat clumsy
3-5 difficulty keeping up with others

Front 157

What are the clinical manifestations of MD?

Back 157

weakness:
proximal before distal
legs before arms
extensors before flexors

Front 158

What is the progression of duchenne's muscular dystrophy?

Back 158

-toe walking
-calf pseudohypertophy
-positive gowers sign
-lumbar lordosis
-multifocal contractures
-trendelenberg gait
-fatigue

Front 159

if a pt has a positive pronator drift test where might they have a disease?

Back 159

upp motor neuron disease

Front 160

what are the sensory tests for the neurodevelopmental exam>?

Back 160

pain, light touch, vibration

Front 161

If a pt has trouble balancing, what may be the problem?

Back 161

cerebellar and proprioception

Front 162

If a patient appears to have a balance problem, but can tandem walk, what type of disorder may they have?

Back 162

proprioception

Front 163

what is the nurse assessing for as the child is stacking blocks?

Back 163

intention tremors

Front 164

where is the most common location of an abnormality if proprioception problems are present?

Back 164

posterior fossa below the tentorium

Front 165

what are the tests to check for coordination?

Back 165

-RAM
-point to point movements
-romberg
-Gait

Front 166

having the child run their heel down their opposite shin is part of the ___ __ __ __ assessment

Back 166

point-to-point movements

Front 167

when should the two point discrimiation test be done?

Back 167

in situations where more quantitative data is needed such as following progression of a cortical lesion

Front 168

What is graphesthesia?

Back 168

having the pt close their eyes and being able to discriminate a drawn number in their hand

Front 169

What is the name of the test where the child identifies a common object in their hand with their eyes closed

Back 169

stereognosis

Front 170

Most children can identify left and right by age __-

Back 170

8

Front 171

how can you determine if a child has left-right confusion?

Back 171

have the child touch his ear with right hand. ask the child to touch examiners right hand with his left hand

Front 172

what are the 4 ways to look for neurodevelopmental markers?

Back 172

1. left to right confusion
2. hand preference
3. dystonic posturing
4. proximal inhibition

Front 173

hand preference is generally established by age __-

Back 173

3

Front 174

if a child were not to use one hand at all it would be a __ sign

Back 174

HARD!

Front 175

hand preference before age 2 is a __ sign

Back 175

soft

Front 176

what is dystonic posturing?

Back 176

Soft sign

stiffening of the extremities during a stressed gait or rhythmic movement

Front 177

What is proxmial inhibition?

Back 177

the inability to inhibit proximal musculature while using distal muscles is a nuerlogic marker

Front 178

how do you assess for proximal inhibition?

Back 178

have the child rapidly alternate opening and closig of fists with arms extended, or by rapidly rotating the wrist while hold the arm up and hand above the head

Front 179

ToF: a nueropsychological evaluation is inexpensive and should be done as part of the well visit

Back 179

FALSE! very expensive

Front 180

What region of the head is most often affected in skull fractures!?

Back 180

parietal

Front 181

What are the types of skull fractures?

Back 181

-simple
-depressed
-compound
-basilar

Front 182

Describe a depressed skull fracture

Back 182

hematoma at the site
piece of bone depressed into brain

Front 183

What are the characteristics of compound skull fractures?

Back 183

-laceration and depressed skull fracture
-dura usually pierced
-skull fragment may be dipslaced into the brain tissue

Front 184

What is the name of the fracture that occurs when you get hit in the center of the nose?

Back 184

basilar

Front 185

what occurs in a basilar fracture?

Back 185

produce dural tears that result in leakage of cerebrospinal fluid

Front 186

what can occur if a basilar fracture is not found

Back 186

recurrent meningitis

Front 187

What occurs in an epidural hematoma?

Back 187

Blood stays between the dural surface and the skull and is usually the result of a tearing of the meningeal artery

Front 188

ToF: epidural hematomas are more common in younger children than adolescents?

Back 188

False: more common in older children because in younger children the middle meningeal artery is not yet embedded in the bony surface of the skull

Front 189

What are the signs of an epidural hematoma?

Back 189

-headache
decreased LOC
-fever
-dilation of the pupil of on the affected side of the brain

Front 190

what is the most common sign of an epidural hematoma?>

Back 190

dilation of the pupil on the AFFECTED side of the brain

Front 191

List the early signs of a basilar skull fracture.

Back 191

-blood behind the tympanic membrane
-nerve paralysis
-deafness or ringing in the ears
-dizziness; nausea, and vomiting
-delayed signs and symptoms
-Battle's sign
-Raccoon sign

Front 192

What is battle's sign?

Back 192

bruising present over the temporal area and is often a sign of basilar skull fracture

Front 193

What Cranial nerve is most likely to be affected by an increase in ICP?

Back 193

CN 6: abducens

Front 194

what are involved in the quick neurological check?

Back 194

-LOC
-Motor function
-Pupillary response
-Vitals signs
-signs of increased intracranial pressure
-glasgow coma scale
-Best eye opening response (1-4)
-Best motor response (1-6)
- Best verbal response (1-5)

Front 195

What is the incidence of meningitis?

Back 195

4-10 cases per year

Front 196

What determines the cause of meningitis.

Back 196

the child's age is the predominant determinants of the common bacteria causes

Front 197

ToF: a stiff neck is a sign of meningitis in newborns.

Back 197

False: you may see a bulging fontanelle

Front 198

At what age is it normal to see a stiff neck with meningitis?

Back 198

>2

Front 199

What is the most common cause of meningitis in the first 2 years of life?

Back 199

neisseria meningitus type B

Front 200

Type C meninigitis is often the bacteria in which age group?

Back 200

adolescents

Front 201

What are the pertinent history items that should be checked with children who may have meningitis?

Back 201

-Progression of illness
-exposure
-history of otitis media
-underlying health problems
-seizures

Front 202

what type of seizures are associated with meningitis?

Back 202

FOCAL!

Front 203

What is kernig's sign?

Back 203

Associated with meningeal irritation and hamstring spasm. The leg is brought up and the child screams of lower back pain

Front 204

The __ sign is a test of nuchal rigidity with head off the table in the HCP's hands. this is a test for ___.

Back 204

Braudzinki; meningitis

Front 205

Describe a positive brudzinski sign.

Back 205

when both the knees are flexed in response to passive flexion of the neck toward the chest.
-Reflex is due to exudate around the roots in the lumbar region

Front 206

What is the proper order to conduct the meningeal sign tests?>

Back 206

Brudzinski sign and then kernig's sign

Front 207

If a child has a positive kernig's sign, what disorder other than meningitis should be assessed?

Back 207

otitis media

Front 208

Describe the presentation of meningitis in children with a VP shunt?

Back 208

-low grade ventriculitis
-headaches
-nausea
-minimal fever
-malaise

Front 209

ToF: a child with a shunt should be considered to have meningitis when presenting with symptoms until proven otherwise

Back 209

true

Front 210

What are the characteristics of viral meningitis?

Back 210

less toxic and acute in presentation and more common in the summer. usually coxsackie B