Peds Neuro (exam 4) :(

S/S of Guillain Barre Syndrome: 1. _ _ or paralysis 2. _ _ 3. hypotension 4. _

muscle weakness, respiratory distress, areflexia

type of spina bifida that may have a closed or open sac containing nerve endings and/or spinal cord

myelomeningocele

An _ patient opens his eyes and looks at the stimuli; appears slightly confused; alertness and interest in surroundings are decreased.

obtunded

for a _ patient you want to shake gently to arouse

obtunded

The least severe form of spina bifida

occulta

#1 cause of cerebral palsy

prematurity

for spina bifida kids, NO _ _

rectal temps

During seizure: #1 priority is _ 1. protect from injury 2. keep _ stable 3. medications _, _

safety, airway, valium, ativan

if a child is having a seizure, put them in the _ _ position. do not put anything in the _

side lying, mouth

Neural tube defects (NTDs) are a group of birth defects in which malformations of the brain and spinal cord occur and the structures lack protection of soft tissue and bone. NTDs develop when the neural tube fails to close during fetal development.

spina bifida

Before a seizure PREPARE: 1. know the _ 2. look for alerts from service animal, behavioral responses, verbal responses, etc

trigger

meningitis can be _ or _

viral or bacterial

ability to _ indicated the severity of cerebral palsy

walk

spina bifida can be diagnosed in utero by ultrasound or positive _ screen

AFP

shunt infection/malfunction can happen at any time but most commonly occurs _-_ months after placement

1-3

a nurse is teaching a newly hired nurse about caring for an infant who is postoperative following a myelomeningocele repair. The nurse should teach the newly hired nurse to monitor the infant for what complication? A. hydrocephalus B. congenital hypotonia C. otitis media D. osteomyelitis

A. hydrocephalus

rare immune system response that causes attacks on myelin

Guillain Barre

a _ _ is used to treat hydrocephalus

VP shunt

after surgery management for spina bifida: 1. bowel/bladder training- _ and _ help with continence and spasms 2. _ is common

anticholinergics, antispasmodics, constipation

for increased ICP, _ are needed to prevent shivering

antipyretics

Reye's syndrome is most commonly caused when children between the ages of 4-14 take _ to treat a viral illness.

aspirin

posturing is a (early or late) sign of increased ICP

late

A _ patient opens his eyes but appears drowsy; answers questions appropriately but falls asleep easily

lethargic

for a _ patient you want to speak in a loud voice

lethargic

Shunt education: 1. do not allow child to _ on shunt side continuously 2. NO contact sports 3. want to take prophylactic antibiotics with _ procedures

lie, dental

diagnosis of meningitis: 1. _ _ 2. blood cultures 3. nose/throat cultures 4. _ panel to rule out a coagulation disorder when there are signs of petechial hemorrhage, shock, or meningococcemia

lumbar puncture, DIC

_ is a diuretic that can be given to treat increased ICP

mannitol

type of spina bifida where there is a CSF fluid filled sac with no nerve endings or spinal cord in it

meningocele

_ of anticonvulsant medications is preferred for management of seziures

monotherapy

S/S of shunt malfunction: 1. _/_ 2. headache 3. bulging fontanels 4. change in behavior 5. lethargy, unresponsiveness 6. _ _ 7. elevated temperature

n/v, sunset eyes

spina bifida management after delivery: 1. keep baby in _ position 2. apply a _ sterile dressing on defect

prone, moist

A _ patient only responds to painful stimuli; verbal responses are absent or slow; responsiveness to painful stimuli ceases.

stuporous

for a _ patient use painful stimuli

stuporous

treatment of increased ICP: 1. keep HOB elevated at least _-_ degrees 2. perform _ q2 hours 3. decompressive _ if needed 4. O2 and resp care. suction only as needed

15-30, PROM, craniectomy

if a child with cerebral palsy can sit by _ years of age they will probably be able to walk

2

Pediatric Glasgow coma scale score _ is considered deep coma

3

Pediatric Glasgow coma scale score _-_ is considered coma

4-8

A nurse is admitting a child who has a UTI and a history of myelomeningocele. After completing the admission history, which of the following actions should the nurse plan to take? A. attach a latex allergy alert identification band B. initiate contact precautions C. post signs in the client's bathroom to strain the client's urine D. administer folic acid with meals

A

Meningitis is common after _ or _, penetrating wounds, skull fractures, contaminated LP equipment

OM, URI

Fluid and pressure buildup in the ventricles and intracranial vault due to either: 1. Increase of CSF production 2. Impedance to absorption 3. Obstruction of flow

hydrocephalus

risk factors of spina bifida 1. poor nutrition (lack of folic acid) 2. prolonged _ 3. DM 4. _ meds

hyperthermia, seizure

progressive encephalopathy with hepatic dysfunction

Reye's syndrome

Alternative therapies for seizure management: 1. _ diet (high fat, low carb) 2. cannabis oil 3. hemispherectomy for _ seizures only

keto, focal

Cushing's Triad (bradycardia, irregular respirations, widened pulse pressure) is a (early or late) sign of increased ICP

late

bulging fontanelles is a (early or late) sign of increased ICP

late

Meningitis is the inflammation of the meninges that is identified by an abnormal RISE in _ in the CSF

WBC

Reye's syndrome affects all organs of a child's body but causes the most damage to the _ and _

brain, liver

no pupil response is a (early or late) sign of increased ICP

late

Guillain Barre Syndrome is most commonly caused by _

campylobacter

disorder of muscle control or coordination caused from in injury to the brain during early development

cerebral palsy

A _ patient does not respond to internal or external stimuli; they remain in an unaroused state with eyes closed

comatose

For a _ patient you want to apply repeated painful stimuli

comatose

_ precautions are indicated for meningitis

droplet

treatment for meningitis: 1. _ precautions 2. _ precautions 3. ICP monitoring 4. HOB elevated 5. decreased _

droplet, seizure, stimuli

change in LOC is a (early or late) sign of increased ICP

early

decreased eye contact in infant is a (early or late) sign of increased ICP

early

emesis is a (early or late) sign of increased ICP

early

headache is a (early or late) sign of increased ICP

early

sunsetting eyes is a (early or late) sign of increased ICP

early

you want to educate parents of children who have had a VP shunt placement for the treatment of hydrocephalus to monitor for _ and notify the provider right away

fever

Meningits S/S: 1. _ 2. _ _ 3. _ _ 4. headache, photophobia, irritability, n/v, nuchal rigidity, seizures

fever, kernig sign, brudzinski

lack of _ _ during the prenatal period is a risk factor of spina bifida

folic acid

after seizure: 1. document _ _, patient response 2. monitor VS, behavior, focused neuro assessment

how long

papilledema (swelling of the optic nerve) is a (early or late) sign of increased ICP

late