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Pediatrics:

Nuerosensory and musculoskeletal disorder

QuestionAnswer
What is meningitis? inflammation of the meninges - protective membranes of the brain and spinal cord.
Which are the type of meningitis? - viral: most common, resolves w/out treatment - bacterial: contagious, high mortality rate
What are risk factors for viral meningitis? viral illnesses
What are risk factors for bacterial meningitis? Upper bacterial resp infections, immunosuppression, injuries that provide direct CSF access, overcrowding
What are s/s of meningitis? HA, N/V, fever and chills, photophobia, nuchal rigidity, +Bruzinski and Kernig's signs, seizures
What is the most definitive diagnostic procedure for meningitis? CSF analysis
What are nursing interventions to lumbar puncture for CSF? NPO 6-8hr, child empties bladder, in fetal position, sedate PRN, clean skin and apply EMLA, take CSF pressure reading
How long should child remain in bed in a flat position to prevent leakage that can result in spinal headache? 4-8 hr
What are CSF findings indicative of meningitis? - cloudy CSF = bacterial, clear CSF = viral - decreased glucose = bacterial - elevated WBC, protein, CSF pressure
What are nursing interventions for meningitis? isolate pt, frequent VS and neuro status, initiate IV fluids, maintain safety, administer Rx meds, decrease environmental stimuli
What is major concern of meningitis? increased ICP (preventions: positioning, avoidance of coughing and straining).
What vaccines protect infants from bacterial meningitis? - PCV (pneumococcal vaccine) - Hib (H. influenzae type B vaccine)
What is Reye syndrome? Acute encephalopathy with fatty degeneration resulting in marked cerebral edema and enlargement of the liver with marked fatty infiltration.
Why are children not given aspirin for viral infections? salicylates have been linked to Reye syndrome.
What are some s/s of Reye syndrome? vomiting usually w/o diarrhea after viral illness, change in LOC, elevated liver enzymes w/o jaundice
What are teachings to prevent Reye syndrome? teach parents to avoid giving salicylates for pain or fever in kids, and they should read OTC meds label for salicylates
What is cerebral palsy (CP)? nonprogressive impairment of motor fx control; manifests differently in each child
What causes CP? brain injuries or anoxia in utero or during delivery
What are warning signs of cerebral palsy in a 3 mo old child? poor head control, no smiling
Why do all children with myelomeningocele have bowel and bladder problem? d/t decreased innervation in sacral area of cord
Neural tube defect has been linked to lack of what nutrient in maternal diet? folic acid --> recommend 400 mcg folic acid for women of childbearing age
What test is done in antenatal period to screen for neural tube defect? amniocentesis for increased AFP levels
What is hydrocephalus? normal circulation of spinal fluid is interrupted --> pressure on the brain, deformity, and progressive enlargement of head.
What is treatment for hydrocephalus? VP shunt
What are nursing interventions for an infant with myelomeningocele? - protect defect with a clear sterile dressing - avoid pressure to area - observe for hydrocephalus - observe infant's ability to move extremities
What is epilepsy? a series of seizures that result from focal or diffuse discharges in cortical neurons
What are safety precautions for a pt admitted for epilepsy? bed in low position, O2 and suction equipment ready
What should RN do after a child's seizure has stopped? note time, assess airway, suction PRN, position pt on side, apply O2, VS, asses for injuries, stay with pt, ensure MD notified, administer meds as Rx
A single seizure lasting <10 min or a series of seizures lasting 20-30 is called what? status epilepticus
What are types of head injuries? concussion, closed injury, fractures, intracranial hematoma
The Glascow Coma Scale assesses what 3 kinds of response? - best eye response - best verbal response - best motor response
What is strabismus? eye misalignment, inability to focus on a single object --> 2x vision (normal up to 6 mo of age)
If left untreated what can otitis media lead to? conductive hearing loss
Created by: odbal24
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