Neuro

decorticate posturing

-"flexor posturing" or "mummy baby" (think Egyptian mummy preservation) -adduction of arms (arms fold to chest); flexion of elbows and wrists

everything but tongue blade and smelling salts

A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included? Select all that apply. oxygen gauge and tubing suction at bedside tongue blade padding for side rails smelling salts

BD

A nurse is assisting with the development of an in-service about viral and bacterial meningitis. The nurse should include that the introduction of which of the following immunizations decreased the incidence of bacterial meningitis in children? Select all that apply. A Inactivated polio vaccine (IPV) B Pneumococcal conjugate vaccine (PCV) C Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) D Haemophilus influenzae type B (Hib) vaccine E Trivalent inactivated influenza vaccine (TIV)

A. Place the client on NPO status

A nurse is caring for a client who has suspected meningitis and a decreased level of consciousness. Which of the following actions should the nurse take? A Place the client on NPO status. B Prepare the client for a liver biopsy. C Position the client dorsal recumbent. D Put the client in a protective environment.

ABD

A nurse is caring for an adolescent who has a closed head injury. Which of the following findings should the nurse identify as manifestations of increased intracranial pressure (ICP)? Select all that apply. A Report of headache B Alteration in pupillary response C Increased motor response D Increased sleeping E Increased sensory response

ABC

A nurse is teaching a group of caregivers about the risk factors for seizures. Which of the following factors should the nurse include in the teaching? Select all that apply. A Febrile episodes B Hypoglycemia C Sodium imbalances D Low blood lead levels E Presence of diphtheria

menigioccemai med emergency

Abrupt eruption of petechiae in kid with meningitis means

for those under 3

Checking head circumference for what ages

frequent falls

Higher center of gravity and larger heads in kids causes what

droplets

How is meningitis transmitted

lying flat for 12 hours

In what position after lumbar puncture

1-2 months

Infection is most common how long after shunt replacement

bulging fontanelle

Late sign of increased ICP with bacterial meningitis in the kid

head circumference

Microcephale is when _________ that is more than three standard deviations below the mean for the age and sex of the infant.

hypoglossal

Motor impulses to the tongue and skeletal muscles is which cranial nerve

viral

Reye syndrome affects those recovering from ____ illness who take aspirin

remove any blankets or clothing and replace with a sheet

The nurse is caring for a preschooler who has developed a high fever and has just had a seizure. What is the best action by the nurse? Place the child in a bathtub filled with cool water. Apply ice packs to the child's axillary and groin area. Administer acetaminophen by mouth as prescribed. Remove any blankets or heavy clothing and replace with a thin sheet

they decrease

What happens to hr and respirations with increased ICP

photphobia

What happens to vision with meningitis

neck muscles not well developed

What is with the neck muscles at a younger age

High Shrill Cry

What kind of cry with hydrocephalus and increased ICP

sutures are not closed

Why can the infant accomodate more fluid in the head

Oil in the hair will mess up the reading

Why is the hair washed before EEG

long term

are vp shunts short term or long term

arms extneded and pronated

decerbate posturing

sunsetting eyes

A sign of increased intracranial pressure. Note the ability to see white all above the iris.

Collection of CSF and blood for culture

Antibiotic therapy to treat meningitis should be instituted immediately after which event? Admission to the nursing unit Initiation of IV therapy Identification of the causative organism Collection of cerebrospinal fluid (CSF) and blood for culture

first 3-4 weeks of life spinal cord is more mobile at birth

Brain devlelops when spinal cord is less or more mobile at birth

its CSF

If clear fluid is positive for glucose what does this mean

causes outside of the brain

Most seizure disorders result from causes inside or outside the brain

take your time feeding the baby

The nurse is educating parents of a male infant with Chiari type II malformation. Which statement about their child's condition is most accurate? "Take your time feeding your baby." "Lay him down after feeding." "You'll see a big difference after the surgery." "You won't need to change diapers often."

Risk for injury

The nurse is preparing a care plan for a child who has a seizure disorder. The child experiences tonic-clonic seizures. Which nursing diagnosis will the nurse identify as having the highest priority? Risk for delayed development Risk for injury Risk for ineffective tissue perfusion: cerebral Risk for self-care deficit: bathing and dressing

A

When compared with adults, why are infants and children at an increased risk of head trauma? The head of the infant and young child is large in proportion to the body and the neck muscles are not well developed. The development of the nervous system is complete at birth but remains immature. The spine is very immobile in infants and young children. The skull is more flexible due to the presence of sutures and fontanels.

Toddlers

Which of these age groups has the highest actual rate of death from drowning? infants toddlers preschool children school-aged children

tonic clonic

Which type of seizure has the aura

every 2 hours to make sure that they still are aware of what is going on

With mild to moderate brain injury wake the kid how often

near drowning

___________- is described as an incident in which a child has suffered a submersion injury and has survived for at least 24 hours

rectal diazepam

_______________ has been shown to be safe and effective in terminating febrile seizures and may be used in children at high-risk for febrile seizures

fixed and dilated

brain stem herniation secondary to increased ICP results in what eyes

early sign

bulging fontanelle and increased head circumference is more early or late sing of increased ICP

late

cheyne stokes respirations are early or late sign of increased ICP

cerebellum

chiair malformation affects which part of the brain

pin point pupils

commonly observed in posioning brain stem dysfunction and opiate use

facial

facial muscles salivation and taste is what cranial nerve

trigemnial

mastication muscles and facial tension is what cranial nerve

brudzinski sign

meningitis, in which there is an involuntary flexion of the arm, hip, and knee when the patient's neck is passively flexed.

myoclonic

sudden brief jerking siezure

atonic seizure

sudden loss of muscle tone seizure

early

sunset eyes seizures sings of early or late increased ICP

102 or higher 15 minutes

•Associated with a rapid rise in core temperature to __________ or higher •A simple febrile seizure is defined as a generalized seizure lasting less than _____ minutes

positional plagiocephaly

•Asymmetry in head shape without fused sutures

febrile seizures

Family history heavily influences what types of seizures

meningitis in the kid

GBS tests during pregnancy are meant to prevent

The use of anticonvulsants

The nurse cares for a 7-year-old child with new-onset seizure disorder. Which prescription will the nurse anticipate for this client? frequent temperature assessment use of anticonvulsant medications ketogenic diet vagus nerve stimulation

Stroke in the kid

oWeakness on one side or hemiplegia oFacial droop oSlurred speech oSpeech deficits

plantar flexed

wite both decortie and decerbae posturing how are the feet

hydrocephalus and the ventroperionteal shutn

•Most cases are treated with the surgical placement of an extra cranial shunt most often a ventricular peritoneal ( VP shunt) is placed and it will need to be revised as the child grows

eye opening best motor response response to auditroy or visual stimuli

3 things we look at with the glasgow coma scale

A

A 7-year-old client has been complaining of headache, coughing, and an aching chest. The care provider makes a diagnosis of a viral infection. The child's mother tells the nurse that when she first said she had a headache, the child's father gave her half of an adult aspirin. The mother has heard of Reye syndrome and asks the nurse if her child could get this. Which statement would be the best response by the nurse? A."This might or might not be a problem. Watch your daughter for signs of lethargy, unusual irritability, confusion, or vomiting. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome." B."This is a serious problem. Aspirin is likely to cause Reye syndrome, and she should be admitted to the hospital for observation as a precaution." C."This is unlikely to be a problem. Half an aspirin is not enough to cause harm. Reye syndrome generally only develops from prolonged use of aspirin in connection with a virus." D."This might or might not be a problem. Watch your daughter for signs of nasal discharge, sneezing, itching of the nose, or dark circles under the eyes. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome."

Teach the child and his parents to keep a headache diary

A 9-year-old boy is suffering from headaches but has no signs of physical or neurologic illness. Which intervention would be most appropriate? Teach the child and his parents to keep a headache diary. Review the signs of increased intracranial pressure with parents. Have the child sleep without a pillow under his head. Have the parents call the doctor if the child vomits more than twice.

A stabilize the childs neck

A nurse is in the emergency department is assessing a child following a motor-vehicle crash. The child is unresponsive, has spontaneous respirations of 22/min, and has a laceration on the forehead that is bleeding. Which of the following actions should the nurse take first? A Stabilize the child's neck. B Clean the child's laceration with soap and water. C Implement seizure precautions for the child. D Initiate IV access for the child.

ABCD

A nurse is reviewing treatment options with the caregiver of a child who has epilepsy and is beginning to have more frequent seizure activity. Which of the following treatment options should the nurse include in the discussion? Select all that apply. A Vagal nerve stimulator B Additional antiepileptic medications C Corpus callosotomy D Focal resection E Radiation therapy

decrease environmental stimulation

A preschool-age child has just been admitted to the pediatric unit with a diagnosis of bacterial meningitis. The nurse would include which recommendation in the nursing plan? Take vital signs every 4 hours Monitor temperature every 4 hours Decrease environmental stimulation Encourage the parents to hold the child

ADE

An infant is brought to the emergency department after falling off the parents' bed and hitting the head. The infant is diagnosed with a concussion and is safe to return home. Which instruction(s) does the nurse provide the parents for home care of this infant? Select all that apply. A. "Have someone in the home with your infant for the next 24 hours." B. "Wake your infant every 6 hours. Your infant should respond normally to waking." C. "Administer acetaminophen every 4 hours for head pain." "Return to the emergency department if your infant vomits more than 2 times." D. "Return to the emergency department if you notice your infant's pupils are different sizes."

mild to moderate brain injury

Brain injury without any penetrating injury to the brain, no loss of consciousness, no other injury to the head or body

that the child is more aware

HIGHER GCS score indicates what

glossopharyngeal and vagus

Motor impulses swallowing and gag reflex is which two cranial nerves

head and neck extended

The infant may be in the opishtonic position to relieve discomfort with meningitis. what is this position?

moving the head every 2 hours

The nurse caring for an infant with craniosynostosis, specifically positional plagiocephaly, should prioritize which activity? moving the infant's head every 2 hours measuring the intake and output every shift massaging the scalp gently every 4 hours giving the infant small feedings whenever he is fussy

I hate to think

The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education? "The next time he has a fever, I need to make sure I read the dosage on the acetaminophen bottle carefully." "I need to set an alarm to wake up and check his temperature during the night when he is sick." "I hate to think that I will need to be worried about my child having seizures for the rest of his life." "When he gets his next set of immunizations, I need to make sure I give him some ibuprofen so he doesn't spike a fever."

minimal or no alteration

The nurse is collecting data from a child who may have a seizure disorder. Which nursing observations suggest an absence seizure? Sudden, momentary loss of muscle tone, with a brief loss of consciousness Muscle tone maintained and child frozen in position Brief, sudden contracture of a muscle or muscle group Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention

drain excess csf

VP shunt is used for hydrocephalus and has what purpouse?

lateral recumbent

appropriate position to put the kid in for lumbar puncture

legs interally rotated elbows and wrists flexed

decorticate posturing

late

decreased loc depressed motr and sensory response early or late sign of increased ICP

ancephaly

defect in brain development resulting in small or missing brain hemispheres, skull and scalp.

late sign

fixed and dilated pupils early or late sign of increased ICP

early signs

headache vomtiign dizziness visual changes early or late sign of increased ICP

dilated

how are the eyes right after seizure

decreasing the pressure in the brain by causing vasoconstriction

hyperventilation may be used as a treatment for what

kernig sign

inability to fully extend the knees with hips flexed.

intracranial mass

one dilated eye is indicative of what

death

prognosis for ancephaly

encephalocele

protrusion of the brain and meninges through a skull defect it results from failure of the anterior portion of the neural tube to close.

•Young and single parent •Premature •Colic

risks for shaken baby

flouroscopy

technique in which x-rays are directed through the body to a fluorescent screen that displays internal structures in continuous motion

diazepam fosphenytoin lorazepam

three drugs used for Status eptilepticus

infection and obstruction

two most common issues with VP shunts

Hydrocephalus, cerebellar tonsils

type 1 chiari malformation is a benign, usually not associated with ____________. Result of __________-- displacing into the upper cervical canal

hydrocephalus and myelomeningocele

type 2 chiaris malformation most common and is associated with ___________ and ____________.

craniosyntosis

•Premature closure of the cranial sutures •Can inhibit brain growth and distorted skull appearance is evident

read

•Second leading cause of unintentional injury related death in children between the ages of 1 and 14. Those at greatest risk of drowning are children 1 to 4 years of age and adolescent males

shunt malfunction

•Signs and symptoms of ____________with hydrocephalus include vomiting, drowsiness and headache

read

•Signs and symptoms of a shunt infection poor feeding, vomiting, decreased responsiveness, seizure activity and signs of local inflammation along the shunt tract

hydrocephalus

•The CSF accumulates within the ventricular system and causes the ventricles to enlarge an increases intracranial pressure to occur

read

•The infants large head size and weak neck muscles place them at an increased risk for head trauma due to violent shaking or cranial impacts compared to adults