I've got a headache
signs of increased intracranial pressure in a 10-year old (name 3)
extreme crankiness
sleepiness
headache
nausea/vomiting
Reye's Syndrome is associated with
viral infection and use of aspirin
The classic example of an upper motor lesion is
cerebral palsy
Diagnosis of seizures is made by
•History and assessment
•Testing: EEG, sleep study, video
The primary reasons to place a shunt in a child with hydrocephalus are
1. Allow brain growth if possible
2. Minimize increased intracranial pressure
3. Easier caregiving
4. Improve quality of life
Signs of increased intracranial pressure in an infant (name 5)
Bulging fontanelle
Tense fontanelle
Split sutures
increased head circumference
Sunsetting
Poor feeding
Irritability
Lethargy
High pitched cry
A lumbar puncture is performed on a child suspected to have bacterial meningitis. A lumbar puncture is obtained and the nurse determines that which results would verify the diagnosis
1.Clear CSF, elevated protein and decreased glucose
2. Clear CSF, decreased pressure and elevated protein
3. Cloudy CSF, elevated protein and decreased glucose
4. Cloudy CSF, decreased protein and decreased glucose
the classic example of a lower motor lesion is
muscular dystrophy
Management of seizures can include (name 4)
Drug therapy (multiples)
Ketogenic Diet
Medical marijuana
Vagus nerve stimulation
Surgical therapy
Which of the following best describes the primary cause of hydrocephalus?
A) Overproduction of cerebrospinal fluid (CSF)
B) Imbalance in CSF production and absorption
C) Decreased cerebral blood flow
D) Intracranial tumor growth
Management of a child with a closed-head injury will include (name 4)
Pain management but NO sedation
ABCs
Neuro exam
elevate head 30 degrees/midline positioning
Imaging
Possible surgery
minimal stimulation
What is the appropriate care for a child with suspected meningitis (name 5)
Establish isolation
Blood cultures
CBC and differential
Lumbar puncture
Atraumatic care
3 weeks of appropriate antibiotics
The parents of a child recently diagnosed with cerebral palsy ask the nurse what they can do to make their child better. The appropriate response by the nurse is
"Unfortunately, the brain injury which caused the cerebral palsy will not get better. The best we can do is to help the child learn to be as independent as possible through therapy."
Seizures are less obvious in infants because
incomplete myelinization of nerves
Which of the following is a potential complication of shunt placement for hydrocephalus?
A) Hypertension
B) Infection
C) Diabetes mellitus
D) Hyperlipidemia
Nursing management of a child with migraines will include
Determination of and reduction of Triggers
Sleep
Nutrition
Stress Reduction
Maintenance of Treatment adherence
Which sign indicates meningeal irritation in an older child?
A) Positive Kernig’s sign
B) Positive Babinski sign
C) Positive Trousseau sign
D) Positive McBurney sign
What is the inheritance pattern of Duchenne Muscular Dystrophy
X-linked recessive
Immediate management of a seizure will include
Maintain patent airway
Ensure safety
Assessment, documentation
Diazepam administration (buccal, nasal, rectal, IV)
Support family
Calf muscle hypertrophy can occur in this disorder
Duchenne's muscular dystrophy
Which long‑term deficits may develop in children after a head injury?
A) Epilepsy
B) Attention‑deficit/hyperactivity disorder
C) Learning or psychiatric disorders
D) All of the above
A 5‑year‑old child presents with fever, headache, stiff neck, and photophobia. Which physical‑exam finding most specifically indicates meningeal irritation?
A) Positive Brudzinski’s sign
B) Positive Babinski sign
C) Positive Romberg sign
D) Positive McBurney sign
When a child with cerebral palsy uses assistive devices, which assessment is a priority for the nurse?
A) Skin integrity assessment
B) Visual acuity testing
C) Hearing evaluation
D) Cardiac stress testing
Which statement about prophylactic antiepileptic drugs for febrile seizures is correct?
A) They are routinely prescribed for all children with febrile seizures
B) They are never used in this population
C) They are not indicated for febrile seizures
D) They are the first‑line treatment for any seizure
Initial post-op management following a VP shunt would include this type of positioning and then changes how and when
initially flat to prevent rapid change in ICP, then in about 48 hours HOB elevated to 30 and then 45 degrees