LOC
Standardized tool used to assess level of consciousness
What is Glasgow Coma Scale
Assessment findings for this neuromuscular disorder include acute peripheral motor weakness with a progressive, usually ascending paralysis
What is Guillain-Barre Syndrome
High pitched cry, irritability, bulging fontanel and dilated scalp veins
What are signs of increased ICP in the INFANT
Bleeding is usually arterial in this type of head injury
What is EPIDURAL hemorrhage
A benign seizure that frequently occurs in infants and toddlers
What is a FEBRILE SEIZURE
Acute illness causing encephalopathy and liver dysfunction
What is Reye Syndrome
Assessing impairment in this age group can be problematic
What is infants & young children
(use pediatric coma scales & involve parents/family if possible)
Clinical features found in approximately 80% of patients with basilar skull fractures (name 2)
What are battle sign (subcutaneous bleeding over the mastoid process), raccoon eyes (bleeding around the orbits), hemotympanum (bleeding behind the tympanic membrane), and halo sign (CSF leakage from the nose or ear)
Nursing interventions to reduce ICP in children (name 3)
Positioning (head of bed up, head midline), pain management, sedation, dim lights, minimal stimulation, Mannitol/hypertonic saline
Characteristics of infants and young children that put them at high risk for head injury (name 2)
What is large head, immature neck muscles, thin skull bones and open fontanels
The biggest factor in decreasing the incidence of bacterial meningitis in infants and young children
What is HIB VACCINE
Fatal outcome likely once these 3 signs appear
What is Cushing's Triad- widening pulse pressure, bradycardia, irregular respirations
Glasgow Coma Score less than or equal to this number is generally accepted as a definition of coma
What is 8
Changes in vital signs or behaviors which may indicate pain in a child with a closed head injury (name 3)
What are INCREASED agitation, pulse, respirations, blood pressure; DECREASED oxygen saturation, grimacing, crying, restless, breath-holding, grunting
The earliest indicator of improvement or deterioration in neurological status
What is LEVEL OF CONSCIOUSNESS
Bleeding between the dura and arachnoid membrane which may be the result of birth trauma, falls, or violent shaking
What is SUBDURAL hemorrhage
A CSF specimen will show these lab values in bacterial meningitis patients
What are INCREASED WBCs, INCREASED protein, and DECREASED glucose
(specimen will also be cloudy and have a positive gram stain)
Preoperative positioning for patient with myelomeningocele
What is Prone
Child cannot be aroused, even by painful stimuli
What is COMA
Assessment for nuchal rigidity in which the child is supine and there is resistance or pain when the knee is flexed and the lower leg extended
What is a positive Kernig sign
LATE sign of increased ICP in an infant/child
What is BRADYCARDIA
Most ominous type of posturing due to severe dysfunction of the midbrain or brainstem
What is DECEREBRATE
Nonprogressive impairment of motor function, especially that of muscle control, coordination, and posture
What is Cerebral Palsy
Two main complications related to Ventriculoperitoneal Shunt
What is Shunt Malfunction and Shunt Infection
The three categories of the Glasgow Coma Scale
What are EYE opening, VERBAL response and MOTOR response
Nursing priority when assessment findings include the sudden appearance of a fixed and dilated pupil(s)
What is remain with the child
(neurologic emergency - high risk for respiratory arrest)
Clinical manifestation of increased ICP in which the eyes are rotated downward and the sclera is visible above the iris
What is setting sun sign
Injuries resulting from acceleration/deceleration
What is Coup and Contracoup
Osmotic diuretic used to treat cerebral edema
What is Mannitol
Type of Spina Bifida which is not visible externally
What is Spina Bifida Occulta