Term
| Pediatric Glasgow Coma Scale |
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Definition
- Eyes
- Verbal response
- Motor Response
- Score of 3-15 (extremely decreased LOC->unaltered LOC)
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Term
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Definition
- Damage indicated- Poisoning
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Term
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Definition
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Term
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Definition
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Term
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Definition
- drooping in one eye-could be due to stroke
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Term
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Definition
- Arms come up, toes point inward
- Not as severe
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Term
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Definition
- toes and arms point out
- indicates severe neurological damage
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Term
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Definition
- CT, MRI, PET, EVP, US, EEG,
- Blood, stool & sputum
- LP-contraindicated w/ IICP
- know allergies to dyes & shellfish before diagnostics performed
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Term
| Nursing Care of Unconscious Child |
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Definition
- Airway
- Reduction of IICP
- Treatment of shock
- Manage Pain
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Term
| Pain Mgmt of Unconsious Child |
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Definition
- S/S: agitation & rigidity, moaning, irritable, thrashing
- VS alterations: increased HR, BP, RR ,ICP. Decreased O2 sat.
- Will medicate for pain, but can mask symptoms
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Term
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Definition
- Fentanyl+midazolam+vecuronium- treats pain, anxiety & provides relaxation
- Have Narcan available
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Term
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Definition
- Causes: lesion, cerebral edema, head injury, inflammation, meningitis, metabolic insult (lead/mercury toxicity)
- S/S infants: poor feeding, cat-cry, irritable, bulging fontanelles, cranial sutures separated, setting sun sign(white sclera visible above pupil), distended scalp veins (no IV)
- S/S kids: ha (like a migraine), vomiting (projectile), seizures, diplopia, blurred vision, declining LOC.
- Nursing: HOB 15-30 degress, side lying to prevent aspiration, minimize noise, stimulation, suctioning is contraindicated, thermoregulation (antipyretics or cooling devices), stool softeners to prevent straining, dry eyes- use drops.
- Treatment: Oxygenation primary concern, cardiac status, fluid/lyte balance, monitor I/O
- Mannitol-decrease cerebral edema
- Pabulon- paralytic for sedation
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Term
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Definition
- Caused by trauma to the head
- Compression & stretching of nerve fibers
- Transient & Reversible
- May have loss of awareness & responsivenss (min-hrs)- go to hospital for evaluation
- followed by amnesia & confusion
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Term
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Definition
- visible bruising & tearing of cerebral tissue
- Not necessarily a fracture
- Bleeds a lot due to tearing of small arteries
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Term
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Definition
- bruising at point of impact (acceleration)
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Term
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Definition
- bruising at site far removed from point of impact (deceleration)
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Term
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Definition
- Much force needed for skull fracture in infant- skull is very pliable
- Hard blow- depression fracture, uncommon-consider abuse
- Low velocity blow- linear fracture, 2-3 yrs of age, asymptomatic
- Basilar- battle sign- bruising behind ear, raccoon eyes
- Diastatic- occurs transverely & widens sutures
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Term
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Definition
- due to blow to side of head.
- see bleed on same side as impact
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Term
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Definition
- collection of blood outside the brain
- can be caused by shaken baby
- retinal hemorrhage indicates shaken baby
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Term
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Definition
- ICP peaks 24-72 hrs after insult
- S/S: watery fluid from nose or ears
- Diagnose w/ glucose test. Sugar indicates CSF
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Term
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Definition
- imbalance in production & absorption of CSF in ventriculary system
- Causes: congenital or aquired: tumors, spina bifida, brain injuries, meningitis
- Communicating: non-obstructive, impaired absorption of CSF
- Non-Communicating: obstruction of flow, not able to drain
- S/S infants: increased OFC, bulging fontanelle, sunken eyes, vomiting, sleepiness, seizures
- S/S kids: increased IICP, ha w/vomiting, blurred vision, poor balance & coordination, memory loss, sun-setting eyes
- Diagostics: US, CT, MRI, X-ray
- Treatment: short term: withdrawal of CSF, Diamox decreases CSF production, VP shunt- long term
- Nursing:Monitor for IICP, prevent infection, HOB no more than 30°, no scalp vein IVs, abdominal distention (ileus-draining)
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Term
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Definition
- inflammation of meninges and/or spinal cord
- Triad s/s: fever, neck stiffness & rigidity and headaches
- seizure in 50%
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Term
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Definition
- acute inflammation of meningeal tissue (arachnoid mater & cerebrospinal infection)
- Medical Emergency
- Caused by: pneumococcus (ear infection too), meningococcus (close contacts, vaccine available), or haemophilus (follows URI, ear/sinus infections)
- Droplet infection-isolation
- Diagnostics: LP definitive, Increased:WBC, protein, ICP, decreased: glucose
- S/S: Triad, n/v, photophobic, positive Kernig's (pain w/flexion of thigh & knee extension), positive Brudzinski's (knees come up with flexion of neck), Opisthotonus- spine becomes tight/tense, extremities bend back, Purpura rash- starts in LE (glass roll test), IICP, hydrocephalus->CP, death
- Treatment: antibiotic therapy (cross BBB)
- Nursing: VS, head circumference, weight, I/O, seizure precautions, isolation until 24 hrs after antibiotic treatment, neuro monitoring, assess for hearing loss
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Term
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Definition
- Caused by: enterovirus, arbovirus, West Nile, HIV, HSV
- S/S: Triad + photophobia
- Diagnostics: Normal glucose & Protein, WBC elevated a little
- Self-limiting 7 days, symptomatic management
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Term
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Definition
- Acute inflammation of brain
- Causes: viruses, bacteria, ticks, CMV, AIDs
- S/S:nonspecific (fever, ha, n/v), malaise, dizziness, stiff neck, ataxia, speech/memory impairment.
- Severe S/S: high fever, stupor, seizures, ocular palsies, paralysis
- Nursing: mgmt of seizures, IICP, respiratory, IV antibiotic therapy for causative agents
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Term
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Definition
- Acute, non-inflammatory encephalopathy with fatty degenerative changes in liver, brain & kidneys
- Krebs cycle is broken.
- Preceding Viral illness: Respiratory, Chickenpox, Diarrhea
- Associated with salicylate & acetaminophen
- Phase 1:
- recovery from viral illness
- vomiting, lethargy, drowsiness
- Normal pupil reaction.
- Phase II:
- Disorientation, Combativeness
- Pupil reaction sluggish
- Phase III
- Obtunded coma, flexion rigidity......
- Phase V
- Respiratory arrest, lose reflexes
- No specific treatment: induced coma, mannitol for IICP & cerebral edema.
- Nursing: Airway, neuro checks, VS, pupil checks, Fluid/lyte, support family, teach no ASA for kids!
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