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90 Cards in this Set
- Front
- Back
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Causes of Brain Injury in Children |
-Falls -Sports -Abuse -MVA -Sleep deprivation -Malnurishment -electrolyte imbalances -exposure to chemicals -high fever >39C or 104F |
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Generalized seizures |
-heriditary -tonic(muscle rigidity, pupils dilate and non responsive) can last seconds -clonic(jerking, diaphoretic, frothy sputum,vomit, urinary incontinence) can last seconds to minutes -post-ictal phase (deep sleep due to exhaustion, no memory) -involves whole brain |
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Seizures Result in Temporary |
Hypoxia Loss of Conciousness |
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Partial Seizures |
-involves part of brain
-can start from simple to complex -Consciousness may or may not be lost -some kind of repetitive activity (lip smacking, blinking) |
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Absence Seizure |
-no convulsions or movements -usually occur in childhood(school age) -stare off into space -often mistaken as daydreaming -often misdiagnoses as ADD -could occur up to 100X a day |
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Cortical dysplasia |
-brain from infancy is not formed properly -can lead to seizure activity |
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Epilepsy |
-condition where someone could have repeated seizures -dilantin given long term -must have therapeutic blood level |
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Status Epilepticus |
-seizure last longer than 5 minutes -brain is being deprived of oxygen -must seek medical attention |
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Febrile Seizures |
-> 39C -usually outgrow it by age 5 |
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Rancho Los Amigos Scale |
-used when a child suffers a concussion -for ages 5-12 -Looking at cognition, behaviour, awareness, interact with enviorment Level 1 - 8 1 - No Response 8 - Appropriate Response |
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Concussion |
-disturbances to brain function caused by a direct or indirect force to head |
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S/S Concussion |
-headache -unsteadiness -impaired brain function -abnormal headache |
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Seizures Precautions |
-protect head -padded side rails -gently lower person to the floor if standing -loosen any restrictive clothing -look at the time -assess severity (what body parts are effective and what is happening) -ensure airway is open |
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Post Seizure |
-Suction -Side-lying recovery position -oxygen -cover them up with blanket -let them sleep |
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Documentation on Seizure |
-Time -Movement -LOC -Parent present? -Comfort measures |
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Who would be interested in the Rancho Los Amigos Scale? |
-Neurologist -speech therapist -OT -PT *anyone involved in rehabilitation |
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ICP |
-Increased Cranial Pressure Early S/S: -decreased response to touch -personality changes -slightly impaired memory -unilateral change in pupil size -headache -slurred speech -dilated pupils -restlessness -irritability Late S/S -posture to painful stimuli -cheynes stokes -irregular resps -change in vitals -only groaning to painful stimuli -decorticate or decerebrate posturing (abnormal posture) -widening pulse pressure |
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Cushings Triad |
-late sign of deteriorating brain function -widening pulse pressure -bradycardia -dyspnea, cheynes stokes with periods of apnea *giving epinephrine IV could result in this |
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Shaken Baby Syndrome |
-first 6-8 weeks, 3-8 months -can be up to 5 years -blood vessels can rupture -permanent brain damage can occur |
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Glascow Coma Scale |
-best eye opening, verbal response and motor response |
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Intellectual Impairment or Disability |
-below-average mental functioning (IQ below 70) -deficit in adaptive behaviour manifested during developmental period |
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Adaptive Behaviour |
Functioning that relates to everyday tasks -language, reading, math, reasoning, memory, social skills, judgement, communication, self management |
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Down Syndrome |
-chromosomal genetic condition - 3 different phenotypes -most common cause of genetic intellectual disability -screening may include maternal serology and amniocentesis -class overt features -May be mild to significantly cognitively delayed |
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FAS/FAE |
Fetal Alcohol Syndrome/Effects -most significant cause of neurological damage in children is prenatal exposure to alcohol -damage varies due to volume ingested, timing during pregnancy, peak blood alcohol levels, genetics and environmental factors -ranging from mild intellectual and behavioural issues to extreme -higher risk for developing mental illnesses |
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Autism |
-developmental disorder manifested by motor sensory, cognitive, and behavioral dysfunction -ranging from mild to severe mental handicap -one of the 4 most common developmental disabilities -usually manifests in first 3 years of life -affects males 3X more than females -diagnosis based on behaviours |
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How does thermoregulation affect a baby? |
*the balance heat production and heat loss -immature functioning -inability to shiver -greater body SA -thin skin - blood vessels are more superficial -decreased subcutaneous tissue -can't communicate |
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How does dehydration affect a baby? |
-vomiting and diarrhea -sunken fontanels -decreased urine output/concentrated urine -dry, sticky mouth -few or no tears -sunken eyes -dry, cool skin -fatigue and dizziness in older child |
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How does safety affect a baby? |
-choking -falling -ingesting harmful substances -falling out of windows -sports activities |
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How does resp compromise affect a baby? |
-less surfactant (reduces surface tension and helps with exchange of oxygen) -smaller airways -softer airway -allergens -low core temp -swaddling -car seats (up to 8 months) -SIDS -cobedding -smokers -baby powder |
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4 Mechanisms for Heat Loss |
-convection - cool draft-conduction - body touches a cold surface -evaporation - fluid loss from the skin -radiation - close to cool area |
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Delivery Room Temp |
25 Degrees |
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Resp Distress in Newborn |
-indrawing, tugging, retraction -barrel chest -nasal flaring -accessory muscle use -grunting -wheezing -decreased O2 sat (>96%) -irritable -lethargic -floppy muscle tone (hypotonia) -pale skin -bluish nail beds or lips |
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Resp system in child compared to adult |
-smaller -more funneled shape compared to cylinder -more forward -less ridged -epiglottis more floppy -less avioli -weaker diaphram -higher RR |
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Does the heart beat in utero? |
yes, usually at 16 weeks |
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Does the fetus breathe? |
motions of breathing but doesn't intake oxygen -so the lungs develop and get stronger |
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Changes in baby's heart after birth |
1. umbilical vein - Days 2. ductus venosus - Days 3. Formane Ovale - Mins 4. Ductus Arteriousus - Hours 5. Umbilical Artery -placenta removed (low resistance to high resistance) -lungs take in air - pushes out fluid (resistance lowers) |
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Function of Ductus Venosus |
-helps bypass the lungs -smooth muscles sense increased oxygen levels and decreased prostaglandin levels - constrict-constriction happens within hours |
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Function of Foramen Ovale |
-septum seperates L and R atrium -closes from pressure of blood -closes within minutes of birth |
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ASD |
Atrial Septal Defect -foramen ovale doesn't close |
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VSD |
Ventricular Septal Defect -opening of ventricular walls -rare |
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ductus venosus |
-bypasses liver -closes within days |
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Patent Ductus Arteriosus |
-open ductus arteriosus -deoxygenated blood mixed with oxygenated blood -increased HR and BP -acidosis |
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Tetrology of Fallow |
-starts with pulmonary stenosis (hardened and narrow passage) -R ventricle becomes hypertrophic -overriding the aorta -ventricle septal defect |
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ASD in depth |
-unknown S/S -poor appetite, poor growth, fatigue, SOB, lung problems, infections (pneumonia) DX -heart murmur hear by doctor with stethoscope, chest xray, EKG, echo |
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VSD in depth |
-unknown cause, during fetal development S/S -faster breathing, tired during feeding, sweating or crying during feeding, gain weight at slower rate |
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PDA in depth |
Patent Ductus Arteriosus -unknown cause, premature babies, down sydrome, mothers with rubella, babies with neonatal resp sydrome S/S -bounding pulse, faster breathing, poor feeding, SOB, sweating during feeding, tire easily, poor growth |
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TOF in depth |
-unknown cause, premature babies, down sydrome, mother with rubella, teratogen exposure
S/S -cyanosis on exertion (when crying and feeding) around mouth/eyes, dizziness, fainting, seizures, arrhythmias, fussiness, clubbing of fingers, "tet" spells |
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Rheumatic Fever |
-systemic autoimmune disease involving joints, heart, and CNS, skin and subcutaneous tissues -triggered by strep infection of the throat -affects connective tissue, causes scarring of mitral valves (mitral stenosis) |
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S/S of Rheumatic Fever |
-joint pain -skin rash -uncontrolled muscle movements(chorea) -inflammation of the heart -subcutaneous nodules -fever -pallor -fatigue -anorexia, weight loss -heart murmur -elevated ESR |
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Heart Failure |
-Right side - back up of blood in systemic venous system -Left side - back up of blood in lungs Early S/S in infants -tachycardia at rest -fatigue during feeding -sweating around scalp and forehead -dyspnea -sudden weight gain |
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Nursing Goals for HF in Children |
-improve respiration -reduce work of the heart -maintain proper nutrition -prevent infection -reduce anxiety of the patient -support and instruct the parents |
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What happens when the valves don't open well (stenose/narrow) |
-valves become thicker and stronger -congestive heart failure and arrythmias may occur -clot formation and stroke can also occur |
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Causes of systemic hypertenion in childhood |
-classified as BP above 95% for the child's age and gender |
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Common S/S of cardiac defects |
-failure to thrive -cyanosis -pallor -visual pulsations of neck veins -irregular pulse -clubbing of fingers -fatigue with activity or feeding -excessive perspiration |
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See-saw breathing |
uneven breathing |
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Scalene retractions |
chest retracts up by clavicle |
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tet spell |
-blue baby -tet baby -fed through tube feed because feeding requires exertion -hold in squat position - promotes oxygenation and blood flow |
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Giving immunizations prior to surgery |
-don't give -exposure to antigens can cause immunosuppression |
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Cystic Fibrosis affects where the most? |
base of the lungs |
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Cystic Fibrosis S/S |
-salt skin - sweating a lot -frothy stools -mucousy cough -can't gain weight -lung infections -breathing issues |
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Croup
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-effects upper airways -"barking" cough -inspiratory stridor -often begins with cold -not life limiting -croup tent - nebulizer spray(steroid reduces inflammation in airways) -goes away on its own |
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Treatment for HF |
-diuretics -reduce fluid -reduce activity |
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How to blow nose for children? |
Keep mouth slightly open in order to prevent bacteria from backflowing
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Reyes Syndrome |
-serious condition causing swelling of liver and brain -liver can't metabolize ASA S/S: severe confusion, decreased LOC |
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Communicable Diseases on the body
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-may cause confusion, seizures with high seizures -airways may be obstructed -pain |
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Meningitis |
-inflammation of outer covering of the brain -high pitch cry -stiff neck |
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Mumps |
-swollen jaw/neck, lymph nodes (peaks on 3rd day) -may include fever, HA, earache, difficulty chewing and swallowing, lymphadenopathy -droplet -cold, soft mushy foods -salt water gargle |
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Mononucleosis |
-Epstein Barr Virus -spread through oral saliva -no treatment |
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Difference between Rubeola and German Measles |
-rubeola has a rash in mouth |
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Scarlet Fever |
-caused by strep bacteria -can lead to respiratory problems and renal failure -can cause strawberry tongue, sore throat, fever, forchheimer spots, vomiting, chills, malaise, tonsillitis, tachycardia -treated with antibiotics -spreads downwards -non infectious after 24 hours of antibiotics |
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meningitis |
-inflammation of the meninges caused by viral or bacterial infection S/S: intense headache and fever, sensitivity to light, and muscular rigidity, leading (in severe cases) to convulsions, delirium, and death. |
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status epilepticus |
a dangerous condition in which epileptic seizures follow one another without recovery of consciousness between them. |
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signs of FAS |
-low birth weight -small head circumference -failure to thrive -developmental delay -organ dysfunction -facial abnormalities, including smaller eye openings, flattened cheekbones, and indistinct philtrum (an underdeveloped groove between the nose and the upper lip) -epilepsy -poor coordination/fine motor skills -poor socialization skills, such as difficulty building and maintaining friendships and relating to groups -lack of imagination or curiosity -learning difficulties, including poor memory, inability to understand concepts such as time and money, poor language comprehension, poor problem-solving skills -behavioral problems, including hyperactivity, inability to concentrate, social withdrawal, stubbornness, impulsiveness, and anxiety |
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canthal folds |
skin fold of upper eyelid |
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intellectual disability |
has been defined as below-average mental functioning (IQ below 70) and a deficit in adaptive behavior(meetings ADLS) manifested during the developmental period |
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Respiratory synctial virus |
(RSV) infection of the lungs and breathing passages, -is a major cause of respiratory illness in children -can lead to serious conditions |
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stenosis |
abnormal narrowing of passage in the body |
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shunt |
passage which allows movement |
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prodromal phase |
first symptom(s) occur |
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incubation period |
the period between exposure to an infection and the appearance of the first symptoms. |
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Exanthema |
-"breaking out" -wide spread rash |
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Fomite |
objects that have been contaminated by an infected person |
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vesicular |
small blister with clear fluid -blister |
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lymphadenopathy |
enlargement of lymph nodes |
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papule |
circular reddened area on skin that is elevated -wart, mole |
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macule |
redenned area, round and flat -freckle, sun spot |
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wheal |
-no fluid, irregular border, slightly raised -hives |
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pustule |
raised, filled with pus -boils, pimples |
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nodule |
-hard lump, no fluid -calcium deposit, bunions, enlarged lymph nodes |
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cyst |
fluid filled or solid |
