Term
| Most common chromosomal abnormality in children |
|
Definition
|
|
Term
| Down syndrome is evidenced by |
|
Definition
| various physical characteristics and by cognitive impairment |
|
|
Term
| Down syndrome results from a trisomy of chromosome |
|
Definition
| 21 and, in less than 5% of cases, a translocation of chromosome 21 |
|
|
Term
| Down syndrome is associated with maternal age |
|
Definition
|
|
Term
| Common physical characteristics of Down Syndrome |
|
Definition
a. flat, broad nasal bridge
b. inner epicanthal eye folds
c. upward, outward slant of eyes
d. protruding tongue
e. short neck
f. transverse palmar crease (simian)
g. hyperextensible and lax joints (hypotonia) |
|
|
Term
| Common associated problems with Down Syndrome |
|
Definition
a. cardiac defects
b. respiratory infections
c. feeding difficulties
d. delayed developmental skills
e. mental retardation
f. skeletal defects
g. altered immune function
h. endocrine dysfunctions |
|
|
Term
| Nursing Diagnoses for Down Syndrome |
|
Definition
A. Delayed growth and development related to...
B. Risk for impaired parenting related to... |
|
|
Term
| for Down's Syndrome: Assist and support parents during the diagnostic |
|
Definition
| process and management of child's associated problems |
|
|
Term
| For Down's Syndrome: Assess and monitor growth and |
|
Definition
|
|
Term
| For Down's Syndrome: Teach parents the following: |
|
Definition
a. use of bulb syringe for suctioning nares
b. signs of respiratory infections
c. assist with feeding problems
d. feed to back and side of mouth
e. refer family to early intervention program |
|
|
Term
| For Down's Syndrome: Refer to other specialists as indicated including: |
|
Definition
| nutritionist, speech therapist, physical therapist, and occupational therapist |
|
|
Term
| For Down's Syndrome: Monitor for signs of |
|
Definition
| cardiac difficulty and/or respiratory infection |
|
|
Term
| The nursing goal in caring for a child with Down Sydrome |
|
Definition
| is to help the child reach his or her optimal level of functioning |
|
|
Term
| Nonprogressive injury to the motor centers of the brain causing neuromuscular problems of spasticity or dyskinesia (involuntary movements) |
|
Definition
|
|
Term
| Associated problems of Cerebral Palsy may include |
|
Definition
| cognitive impairment and seizures |
|
|
Term
| What causes Cerebral Palsy? |
|
Definition
Causes include:
a. anoxic injury before,during, or after birth
b.maternal infections
c. Kernicterus
d. Low birth weight (major risk factor) |
|
|
Term
| Nursing Assessments for Cerebral Palsy: |
|
Definition
a. Persistent neonatal reflexes (Moro, tonic neck) after 6 months
b. delayed developmental milestones
c. apparent early preference for one hand
d. poor suck, tongue thrust
e. spasticity (may be described as difficulty with diapering by caregiver)
f. scissoring of legs (legs are extended and crossed over each other, feet are plantar flexed; a common characteristic of spastic CP)
G. involuntary movements
H. Seizures |
|
|
Term
| Nursing Diagnoses for Cerebral Palsy |
|
Definition
A. Delayed growth and development related to...
B. Risk for imbalanced nutrition: less than body requirements related to... |
|
|
Term
| Nurses should monitor and identify CP through |
|
Definition
| follow-up of high-risk infants such as premature infants |
|
|
Term
| With Cerebral Palsy, refer to community-based agencies and coordinate with |
|
Definition
| physical therapist, occupational therapist, speech therapist, nutritionist, orthopedic surgeon and neurologist |
|
|
Term
| Feed infant or child with cerebral palsy using nursing interventions aimed at preventing |
|
Definition
| aspiration. Position child upright, and support the lower jaw. |
|
|
Term
| For CP, Support family through grief process at diagnosis and throughout |
|
Definition
| the child's life. Caring for severely affected children is very challenging. |
|
|
Term
| For CP, adminster anticonvulsant medications such as |
|
Definition
| phenytoin (Dilantin) if prescribed |
|
|
Term
| For muscle spasms in CP, administer |
|
Definition
| diazepam (Valium) if prescribed. |
|
|
Term
| List of anticonvulsants commonly prescribed: |
|
Definition
a. Phenobarbital (Luminal) PO, IM, IV
b. Phenytoin (Dilantin)PO, IV
c. Fosphenytoin sodium (Cerebyx) IM, IV
d. Valproic acid (Depakene) PO
e. Carbamazepine (Tegretol) PO
f. Lamotrigine (Lamictal) PO
g. Clonazepam (Klonopin) PO |
|
|
Term
| Indications for the use of the anticonvulsant Phenobarbital (Luminal) |
|
Definition
a. Tonic-clonic and partial seizures
b. Is the longest acting of common barbituates
c. usually compined with other drugs |
|
|
Term
| Adverse reactions for the anticonvulsant Phenobarbital (Luminal) |
|
Definition
| Drowsiness, Nystagmus, Ataxia, Paradoxic excitement |
|
|
Term
| Nursing implications of the anticonvulsant Phenobarbital (Luminal) |
|
Definition
Therapeutic levels: 15 to 40 mcg/mL
Avoid rapid IV infusion
Monitor blood pressure during IV infusion |
|
|
Term
| Indications for the anticonvulsant Phenytoin, (Dilantin) |
|
Definition
| Tonic-clonic and partial seizures |
|
|
Term
| Adverse reactions seen in the anticonvulsant Phenytoin (Dilantin) |
|
Definition
| Gingival hyperplasia, Dermatitis, Ataxia, Nausea, anorexia, Bone-marrow depression, Nystagmus |
|
|
Term
| Nursing Implications of the anticonvulsant Phenytoin (Dilantin) |
|
Definition
| Therapeutic levels 10 to 20 mcg/mL; monitor any druginteractions; do not administer with milk; ensure meticulous oral hygiene; monitor CBC; Report to physician if any rash develops; For IV administration flush IV line before and after with normal saline only |
|
|
Term
| Indications for the anticonvulsant Fosphenytoin sodium (Cerebyx) |
|
Definition
| Generalized convulsive status epilepticus; prevention and treatment of seizures during neurosurgery; short-term parenteral replacement for phenytoin oral (Dilantin) |
|
|
Term
| Adverse seen in the anticonvulsant Fosphenytoin sodium (Cerebyx) |
|
Definition
| Rapid IV infusion can cause hypotension; severe ataxia CNS toxicity, confusion, gingival hyperplasia, irritabiltiy, lupus erythermatosus, nervousness, nystagmus, paradoxic excitement, Stevens-Johnson syndrome, toxic epidural necrosis |
|
|
Term
| Nursing implications for Fosphenytoin sodium (Cerebyx) |
|
Definition
a. Use for short term parenteral use (IV infusion or IM injection) only
b. should always be prescribed and dispensed in phenytoin sodium equivalents (PEs)
c. Prior to IV infusion, dilute in D5W or NS to administer
d. Infuse at IV rate of no more than 150 mg PE/min |
|
|
Term
| Indications for the anticonvulsant Valproic acid (Depakene) |
|
Definition
Absence seizures
Myoclonic seizures |
|
|
Term
| Adverse reactions seen in anticonvulsant Valproic acid (Depakene) |
|
Definition
| Hepatotoxicity, especially in children less than 2 years old; prolonged bleeding times; GI disturbances |
|
|
Term
| Nursing implications seen in anticonvulsant Valproic acid (Depakene) |
|
Definition
monitor liver function
potentiates phenobarbital and Dilantin, altering blood levels
Therapeutic levels 50 to 100 mEq/mL |
|
|
Term
| Indications for Carbamazepine (Tegretol) |
|
Definition
Tonic-clonic, mixed seizures
Drowsiness
Ataxia |
|
|
Term
| Adverse reactions for Carbamazepine (Tegretol) |
|
Definition
|
|
Term
| Nursing Implications for Carbamazepine (Tegretol) |
|
Definition
Monitor liver function while on therapy
Therapeutic levels 6 to 12 mcg/mL |
|
|
Term
| Indications for anticonvulsant Lamotrigine (Lamictal) |
|
Definition
a. Partial seizures
b. tonic-clonic seizures
c. absence seizures |
|
|
Term
| Adverse reactions seen in Lamotrigine (Lamictal) |
|
Definition
a. dizziness
b. headache
c. nausea
d. rash |
|
|
Term
| Nursing implications seen in Lamotrigine (Lamictal) |
|
Definition
a. Withhold drug if rash develops
b. Do not discontinue abruptly |
|
|
Term
| Indications for the anticonvulsant Clonazepam (Klonopin) |
|
Definition
absence seizures
myoclonic seizures |
|
|
Term
| Adverse Reactions for the anticonvulsant Clonazepam (Klonopin) |
|
Definition
a. drowsiness
b. hyperactivity
c. agitation
d. increased salivation |
|
|
Term
| Nursing implications for the anticonvulsant Clonazepam (Klonopin) |
|
Definition
Therapeutic levels 20 to 80 mcg/mL
Do not abruptly discontinue durg
Monitor liver function, CBC and renal function periodically |
|
|
Term
| It is classified under DSM-IV. However, recent studies indicate that these disorders are neurologic. |
|
Definition
| Attention Deficit Disorder, Attention Deficit Hyperactivity Disorder |
|
|
Term
| Malformation of the vertebrae and spinal cord resulting in varying degrees of disability and deformity |
|
Definition
|
|
Term
| A defect of vertebrae only. No sac is present, and it is usually a benign condition although bowel and bladdere problems may occur. |
|
Definition
|
|
Term
| In Spina Bifada with meningocele and myelomeningocele a sac |
|
Definition
| is present at some point along the spine |
|
|
Term
| In Spina Bifida meningocele contains only |
|
Definition
| meninges and spinal fluid and has less neurologic involvement than myelomeningocele |
|
|
Term
| In Spina Bifida myelomeningocele is more severe |
|
Definition
| than meningocele because the sac contains spinal fluid, meninges, and nerves |
|
|
Term
| In Spina Bifida, the severity of neurologic impairment is determined by |
|
Definition
| the anatomic level of the defect |
|
|
Term
| Meningocele contains only meninges and |
|
Definition
| spinal fluid and has less neurologic involvement than myelomeningocele |
|
|
Term
| Myelomeningocele is more severe than meningocele because |
|
Definition
| the sac contains spinal fluid, meninges and nerves |
|
|
Term
| The severity of neurologic impairment in spina bifida is determined by |
|
Definition
| the anatomic level of the defect |
|
|
Term
| Every child with a history of spina bifida should be screened for |
|
Definition
|
|
Term
| To prevent spina bifida, folic acid is taken daily at least |
|
Definition
| 3 months prior to pregnancy. The dosage should be increased during pregnancy. |
|
|
Term
|
Definition
| dimple with or without hair tuft at the base of spine |
|
|
Term
| In spina bifida, presence of sac in myelomeningocele is usually |
|
Definition
|
|
Term
| In spina bifida there is flaccid paralysis and limited or no feeling below the |
|
Definition
|
|
Term
| In spina bifida, assess head circumference at variance |
|
Definition
| with norms on growth grids |
|
|
Term
| Associated problems with Spina bifida: |
|
Definition
a. hydrocephalus (90% with myelomeningocele)
b. neurogenic bladder, poor anal sphincter tone
c. congenital dislocated hips
d. club feet
e. skin problems associated with anesthesia below the defect
f. scoliosis |
|
|
Term
| Nursing Diagnoses for Spina bifida |
|
Definition
a. Risk for infection related to...
b. Impaired urinary elimination patterns related to...
c. Impaired physical mobility related to... |
|
|
Term
| What position should the infant be for spina bifida preoperatively? |
|
Definition
| Place infant in prone position |
|
|
Term
| Before surgery for spina bifida, what should you do with the sac? |
|
Definition
| Cover it with moist sterile dressing. |
|
|
Term
| Preoperative: Nursing interventions: |
|
Definition
A. Elevate foot of bed and position child on his or her abdomen with legs abducted
B. Measure head circumference at least every 8 hours or every shift; check fontanel
C. Assess neurologic function
D. Monitor for signs of infection
E. Empty bladder using Crede method or catheterize if needed
F. Promote parent-infant bonding |
|
|
Term
| Spina Bifida -Postoperatively: Nursing Interventions: |
|
Definition
A. Place infant in prone position
B. Make assessments as preoperatively
C. Assess incision for drainage and infection
D. Assess neurologic function |
|
|
Term
| Spina Bifida - Teach Family catheterization program |
|
Definition
|
|
Term
| Spina Bifida - Help older children learn to |
|
Definition
|
|
Term
| Spina Bifida - Administer these two drugs to improve continence: |
|
Definition
propantheline (Pro-Banthine) or
bethanecchol (Urecholine)
as prescribed |
|
|
Term
| For Spina bifida, develop a bowel program that includes: |
|
Definition
a. high fiber diet
b. increased fluids
c. regular fluids
d. suppositories as needed |
|
|
Term
| For Spina bifida, assess skin condition frequently and assist with |
|
Definition
| range-of motion (ROM) exercises, ambulation, and bracing if client is able. |
|
|
Term
| For Spina bifida, coordinate with team members such as |
|
Definition
| neurologist, orthopedist, urologist, physical therapist, and nutritionist |
|
|
Term
| For Spina bifida, support independent functioning |
|
Definition
| of child and assist family to make realistic developmental expectations of child. |
|
|
Term
| Condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) with the ventricles of the brain. |
|
Definition
|
|
Term
| Hydrocephalus is usually caused by |
|
Definition
| an obstruction in the flow of CSF between the ventricles of the brain |
|
|
Term
| Hydrocephalus is most often associated with |
|
Definition
| spina bifida; it can be a complication of meningitis |
|
|
Term
| Signs of increased intracranial pressure (ICP) ae opposite of those of shock: |
|
Definition
a. shock increased pulse, decreased blood pressure
b. Increased ICP - decreased pulse, increased blood pressure |
|
|
Term
| Signs of Increased intracranial pressure (ICP) in older children: |
|
Definition
a. change in level of consciousness (LOC)
b. irritability
c. vomiting
d. headache on awakening
e. motor dysfunction
f. unequal pupil response
g. seizures
h. decline in academics
i. change in personality |
|
|
Term
| Signs of increased intracranial pressure (ICP) in infants: |
|
Definition
a. irritability, lethargy
b. increasing head circumference
c. bulging fontanels
d. widening suture lines
e. "sunset" eyes
f. high-pitched cry |
|
|
Term
| In order to detect increased intracranial pressure early, |
|
Definition
| baseline data on the child's usual behavior and level of development are essential so changes can be detected |
|
|
Term
| Nursing diagnoses for Hydrocephalus |
|
Definition
a. Delayed growth and development related to...
b. Risk for injury related to... |
|
|
Term
| Hydrocephalus nursing interventions: |
|
Definition
a. prepare infant and family for diagnostic procedures
b. monitor for signs of increased ICP
c. maintain seizure precautions
d. elevate head of bed |
|
|
Term
| Hydrocephalus - Prepare parents for surgical procedure and explain |
|
Definition
1. shunt is inserted into ventricle
2. tubing is tunneled through skin to peritoneum where it drains excess CSF |
|
|
Term
| Hydrocephalus - Postoperative care for infant includes: |
|
Definition
Assess for signs of shunt malfunction
a. infant - increase in ICP
1) change in size, signs of bulging, tenseness in fontanels, and separation of suture lines
2)irritability, lethargy, or seizure activity
3)Altered vital signs and feeding behavior
4)assess for signs of infection (meningitis)
5) monitor I&O closely |
|
|
Term
| Hydrocephalus - Postoperative care for older child includes: |
|
Definition
Assess for signs of shunt malfunction
Older child - increase in ICP
1) change in LOC
2)complaint of headache
3) changes in customary behavior (sleep patterns, developmental capabilites)
4) Assess for signs of infection (meningitis)
5) monitor I&O closely |
|
|
Term
| For Hydrocephalus - do not pump shunt unless |
|
Definition
| specifically prescribed - the shunt is made up of delicate valves, and pumping changes the pressures within the ventricles. |
|
|
Term
| For Hydrocephalus - teach the following home care: |
|
Definition
a. teach to watch for signs of increased ICP and infection
b. note that child will eventually outgrow shunt and show symptoms of difficulty
c. note that child will need shunt revision
d. provide anticipatory guidance for potential problems with growth and development |
|
|
Term
| Uncontrolled electrical discharges of neurons in the brain |
|
Definition
|
|
Term
| Seizures are more common in children under the age of |
|
Definition
|
|
Term
| Seizures can be associated with |
|
Definition
| immaturity of the CNS, fever, infection, neoplasms, cerebral anoxia, and metabolic disorders |
|
|
Term
| Seizures are categorized as |
|
Definition
|
|
Term
| Generalized seizures are: |
|
Definition
a. tonic-clonic (grand mal) -- consciousness is lost; in tonic phase generalized stiffness of entire body; in the clonic phase spasm followed by relaxation
b. Absence (petit mal): momentary loss of consciousness, posture is maintained; has minor face, eye and hand movements
c. myoclonic - sudden brief contractures of muscle or group of muscles, no postictal state, may or may not be symmetrical or include loss of consciousness |
|
|
Term
|
Definition
| from a specific area in the brain and cause limited symptoms. Examles are focal and psychomotor seizures |
|
|
Term
| Assessment for a Tonic-clonic seizure (grand mal): |
|
Definition
a. aura (a warning sign of impending seizure
b. loss of consciousness
c. tonic phase generalized stiffeness of entire body
d. apnea, cyanosis
e. clonic phase spasms followed by relaxation
f. pupils dilated and nonreactive to light
g. incontinence
h. postseizure: disoriented, sleepy |
|
|
Term
| Assessment for Absence seizures (petit mal): |
|
Definition
a. onset between 4 and 12 years of age
b. last 5 to 10 seconds
c. child appears to be inattentive, daydreaming
d. poor performance in school |
|
|
Term
| What is the most common cause of increased seizure activity? |
|
Definition
|
|
Term
| Nursing Diagnoses for seizures |
|
Definition
a. Risk for injury; trauma related to...
b. Noncompliance related to... |
|
|
Term
| During a seizure do not use |
|
Definition
| a tongue blade, padded or not. It can cause traumatic damage to the oral cavity. |
|
|
Term
| Maintain airway during a seizure -- turn |
|
Definition
| client on side to aid ventilation and do not restrain client |
|
|
Term
| Protect client form injury during seizure and support |
|
Definition
| head (avoid neck flexion) |
|
|
Term
| Document seizure, noting all |
|
Definition
|
|
Term
| Maintain the following seizure precautions: |
|
Definition
a. reduce environmental stimuli as much as possible
b. pad side rails or crib rails
c. have suction equipment and oxygen quickly assessible
d. tape oral airway to the head of the bed. |
|
|
Term
| For seizures support during diagnostic tests |
|
Definition
| EEG, CT scan and support during workup for infections such as meningitis |
|
|
Term
|
Definition
| anticonvulsant medications as prescribed |
|
|
Term
| For tonic-clonic seizures the following medications are often prescribed: |
|
Definition
| phenytoin (Dilantin), carbamazepine (Tegretol, phenobarbital (Luminal)and fosphenytoin (Cerebyx) |
|
|
Term
| For absence seizures the following medications are often prescribed: |
|
Definition
| ethosuximide (Zarontin), valproic acid (Depakene) |
|
|
Term
|
Definition
|
|
Term
| Teach family about drug administration: |
|
Definition
| dosage, action, and side effects |
|
|
Term
| Bacterial inflammatory disorder of the meninges that cover the brain and spinal cord |
|
Definition
|
|
Term
| Meningitis is usually cause by |
|
Definition
| Haemophilus influenze type B (less prevalent), Streptococcus pneumoniae, or Neisseria meningitidis |
|
|
Term
| In Bacterial meningitis the usual source of bacterial invasion |
|
Definition
| is the middle ear or the nasopharynx |
|
|
Term
| In Bacterial meningitis, other sources of bacteria from wounds include |
|
Definition
| fractures of the skull, lumbar punctures, and shunts |
|
|
Term
| In Bacterial meningitis, exudate covers the brain |
|
Definition
| and cerebral edema occurs |
|
|
Term
| In Bacterial meningitis a lumbar puncture shows |
|
Definition
a. increased WBC
b. decreased glucose
c. elevated protein
d. increased ICP
e. positive culture for meningitis |
|
|
Term
| Nursing assessment for Bacterial meningitis for older children: |
|
Definition
a classic signs of increased ICP
b. fever, chills
c. neck stiffness, opisthotonos
d. photophobia
e. positive Kernig sign (inability to extend leg when thig is flexed anteriorly at hip)
f. Positive Brudzinski sign (neck flexion causing adduction and flexion movements of lower extremities) |
|
|
Term
| Nursing assessment for Bacterial meningitis for infants: |
|
Definition
a. absence of classic signs
b. ill, with generalized symptoms
c. poor feeding
d. vomiting, irratibility
e. bulging fontanel (an important sign)
f. seizures |
|
|
Term
| Nursing Diagnoses for Bacterial meningitis: |
|
Definition
A. Nausea (specify) related to...
B. Risk for trauma related to... |
|
|
Term
| For Bacterial meningitis, administer the following: |
|
Definition
| antibiotics (usually ampicillin, ceftriaxone, or chloramphenicol) and antipyretics as prescribed |
|
|
Term
| For Bacterial meningitis, isolate for |
|
Definition
|
|
Term
| For Bacterial meningitis monitor |
|
Definition
| vital signs and neurologic signs |
|
|
Term
| For Bacterial meningitis, keep environment |
|
Definition
| quiet and darkened to prevent overstimulation |
|
|
Term
| For Bacterial meningitis, implement |
|
Definition
|
|
Term
| For Bacterial meningitis, position |
|
Definition
| for comfort, head of bed slightly elevated with child on side if prescribed |
|
|
Term
| For Bacterial meningitis measure infant's |
|
Definition
|
|
Term
| For Bacterial meningitis, monitor |
|
Definition
| I&O closely and monitor hydration status and IV therapy carefully |
|
|
Term
| For prevention of Bacterial meningitis administer |
|
Definition
| Hib vaccine to protect against H. influenzae infection |
|
|
Term
| With Bacterial meningitis, there may be inappropriate |
|
Definition
| ADH secretions causing fluid retention (cerebral edema) and dilutional hyponatremia |
|
|
Term
| Acute, rapidly progressing encephalopathy and hepatic dysfunction |
|
Definition
|
|
Term
| Causes of Reye Syndrome include |
|
Definition
| antecedent viral infections such as influenza or chickenpox |
|
|
Term
| Reye Syndrome is often associated with |
|
Definition
|
|
Term
| Reye Syndrome disease is staged according to the |
|
Definition
| clinical manifestations to reflect the severity of the condition |
|
|
Term
| Reye syndrome usually occurs in |
|
Definition
|
|
Term
| Reye syndrome, can have lethargy rapidly progressing to |
|
Definition
| deep coma (marked cerebral edema) |
|
|
Term
|
Definition
| vomiting, elevated AST,ALT, lactate dehydrogenase, serum ammonia, decreased PT and hypoglycemia |
|
|
Term
| Nursing Diagnoses for Reye Syndrome |
|
Definition
Excess fluid volume related to...
Ineffective breathing pattern related to... |
|
|
Term
| Interventions for Reye Syndrome; |
|
Definition
A. Provide critical care early in syndrome
B. Monitor neurologic status: frequent noninvasive assessments and invasive ICP monitoring
C. maintain ventilation
D. Monitor cardiac paremeters (I.e. invasive cardiac monitoring system)
E. Monitor I&O accurately
F. Care for Foley catheter
G. Provide family with emotional support |
|
|
Term
| To increase blood osmolality for Reye Syndrome administer |
|
Definition
|
|
Term
| Indications for the drug Mannitol (Osmitrol) IV |
|
Definition
| Osmotic diuretic used to reduce cerebral edema and postoperative swelling or trauma |
|
|
Term
| Adverse reactions seen in the drug Mannitol (Osmitrol) IV |
|
Definition
a. circulatory overload
b. confusion
c. hypokalemia
d. hyponatremia |
|
|
Term
| Nursing implications for the drug Mannitol (Osmitrol) IV |
|
Definition
Use inline filter for IV administration and avoid extravasation
Monitor I&O
Lasix may also be prescribed |
|
|
Term
| Second most common cancer in children |
|
Definition
|
|
Term
| Most pediatric brain tumors are infratentorial making them |
|
Definition
| difficult to to excise surgically |
|
|
Term
| Brain tumors usually occur close |
|
Definition
|
|
Term
| The most common childhood brain tumors are |
|
Definition
|
|
Term
| The following nursing assessments need to made in brain tumors: |
|
Definition
a. headache
b. vomiting (usually in the morning) often without nausea
c. change in behavior or personality
d. vision problems, tilting of head
e. loss of concentration
f. in infants, widening of sutures, increasing frontal occipital circumference, tense fontanel |
|
|
Term
| Nursing Diagnoses in Brain Tumors |
|
Definition
a. Ineffective tissue perfusion (cerebral) related to...
b. Risk for trauma related to...
c. Risk for infection (postoperative) related to... |
|
|
Term
| For Brain tumors identify baseline |
|
Definition
|
|
Term
| For brain tumors, support family and child during |
|
Definition
| diagnostic workup and treatment |
|
|
Term
| In brain tumors, if surgery is the treatment of choice, provide the following preoperative teaching: |
|
Definition
a. explain that the head will be shaved
b. describe ICU, dressings, IV lines, etc.
c. identify child's developmental level, and plan teaching accordingly |
|
|
Term
| Assess family's response to the diagnosis of brain tumor |
|
Definition
| and treat family appropriately |
|
|
Term
| After surgery for a brain tumor, position client |
|
Definition
| as prescribed by the health care provider |
|
|
Term
| For brain tumors, most postoperative clients with infratentorial tumors are prescribed to lie |
|
Definition
| flat or turn to either side |
|
|
Term
| A large brain tumor may require that the child not be turned to the |
|
Definition
|
|
Term
| For brain tumors, monitor IV fluids and output carefully. Overhydration can cause |
|
Definition
| cerebral edema and increased ICP |
|
|
Term
| For brain tumors administer |
|
Definition
| steroids and osmotic diuretics as prescribed |
|
|
Term
| Support child and family to promote |
|
Definition
| optimum functioning postoperatively |
|
|
Term
| What things can cause increased ICP? |
|
Definition
| suctioning, coughing, straining, and turning |
|
|
Term
| Inherited disease of the muscles causing muscle atrophy and weakness |
|
Definition
|
|
Term
| The most serious and most common of the dystrophies |
|
Definition
| is Duchenne muscular dystrophy, an X-linked recessive disease affecting primarily males |
|
|
Term
| Duchenne muscular dystrophy appears in early |
|
Definition
| childhood (3 to 5 years). It rapidly progresses, causing respiratory or cardiac complications and death, usually by 25 years of age |
|
|
Term
| For muscular dystrophy the following is assessed: |
|
Definition
a. waddling gait, lordosis
b. increasing clumsiness, muscle weakness
c. Gowers sign: difficulty rising to standing position, has to "walk up" legs, using hands |
|
|
Term
| Other nursing assessments for muscular dystrophy: |
|
Definition
d. pseudohypertrophy of muscles (especially noted in calves) due to fat deposits
e. muscle degeneration, especially the thighs, and fatty infiltrates (detected by muscle biopsy), cardiac muscle also involved
f. delayed cognitive development
g. elevated CPK and ALT/AST
h. later in disease: scoliosis, respiratory difficulty, and cardiac difficulties
i. eventual wheelchair dependency, confinement to bed |
|
|
Term
| Nursing Diagnoses for muscular dystrophy |
|
Definition
Impaired physical mobility related to...
Chronic low self-esteem related to... |
|
|
Term
| The following should be provided for a patient with muscular dystrophy: |
|
Definition
| supportive care, exercises (Passive and active), |
|
|
Term
| In muscular dystrophy prevent exposure to |
|
Definition
|
|
Term
| In muscular dystrophy encourage a balanced diet to avoid |
|
Definition
|
|
Term
| For muscular dystrophy: Support family's grieving process and support participation in |
|
Definition
| the Muscular Dystrophy Association |
|
|
Term
| For muscular dystrophy: Coordinate with health care team including: |
|
Definition
| physical therapist, occupational therapist, nutritionist, neurologist, orthopedist, and geneticist |
|
|
Term
|
Definition
| A common characteristic of spastic cerebral palsy in infants; legs are extended and crossed over each other, feet are plantar flexed |
|
|
Term
| What arpe two nursing priotities for a newborn with myelomeningocele? |
|
Definition
| prevention of infection of the sac and monitoring for hydrocephalus (measure head circumference, check for fontanel bulging, assess neurological functioning) |
|
|
Term
| What teaching should parents of a newly shunted child receive> |
|
Definition
| Information about signs of infection and increased ICP; understanding that shunt should not be pumped and that child will need revisions with growth; guidance concerning growth and development |
|
|
Term
| What antibiotics are usually prescribed with bacterial meningitis> |
|
Definition
| ampicillin, ceftriaxone, or chloramphenicol |
|
|
Term
| Describe the function of an osmotic diuretic: |
|
Definition
| Osmotic diuretics remove water from the CNS to reduce cerebral edema |
|
|
